Whiplash Injury – Symptoms, Causes, Diagnosis and Treatment

Whiplash injury is a common neck injury resulting from a forceful movement of the neck - often forwards and backwards - like the cracking of a whip, hence the name. This can result in pain, stiffness, and affect how much you can move your neck, which can interfere with daily life. Whiplash injury is a term more commonly used to describe a neck strain that has resulted from a motor vehicle accident. However a whiplash injury can also result from falls and sudden jolts as well as posture and movement related tasks. Though most people recover within a few weeks, some people can develop chronic neck pain. In this article, we’ll explore what a whiplash injury feels like, its causes, how it’s diagnosed, and the treatments that can help alleviate symptoms and support recovery.

Disclaimer: Disclaimer: MoreGoodDays® does not endorse any specific whiplash injury or neck pain treatments, procedures, products or physicians referenced in this article. This information is provided for educational purposes only and is not intended to form medical advice. Anyone seeking treatment for their whiplash injury should consult their own trusted healthcare team.

What is a whiplash injury?

A whiplash injury primarily affects the muscles of the cervical spine, especially the levator scapulae and trapezius muscles, as well as the joints in the neck. 

Another term you may come across when discussing a whiplash injury is Whiplash-Associated Disorder (WAD). This describes a collection of symptoms resulting from a rapid, forceful movement of the neck, often experienced in a car accident or sudden physical impact. 

While most whiplash injuries are not dangerous, untreated neck strain can lead to chronic issues if symptoms do not improve within a few weeks. Chronic neck pain can be more complex with a range of physical and psychological factors. Without timely care, the muscles, joints, or nerves in your neck can become even more sensitive, making the pain harder to manage and increasing the risk that it could turn into a longer-term problem.

What does a whiplash injury feel like?

The experience of a whiplash injury can vary, but it typically includes several hallmark symptoms:

• Localized pain: A whiplash injury can cause a throbbing, aching, or sharp pain that often intensifies with movement. The pain is generally concentrated around the neck and upper back.
• Muscle spasms and stiffness: The body’s response to injury can lead to muscle spasms, which contribute to stiffness and make movement challenging. This stiffness, also known as “wry neck,” can make even simple movements like turning your head difficult.
• Headaches: Headaches stemming from the neck are common with whiplash, often described as a dull ache at the base of the skull.
• Emotional response: For those who are experiencing a whiplash injury following a motor vehicle accident, it is common to feel upset, anxious or constantly ‘on high alert’, frustrated and angry or uncertain. In some people, the experience can cause post-traumatic stress disorder symptoms. 
• Additional complications: In some cases, individuals experience dizziness, visual disturbances, a sense of instability, or issues with balance and fine motor skills. While these symptoms can be concerning, they are often temporary and tend to resolve with treatment.

When to see a doctor

Seeking medical care early can help prevent complications and promote more effective recovery.There are some “red flags” for whiplash injury that should never be ignored, regardless of the cause. 

If you have difficulty urinating, lose bowel control, feel numb in your lower body, or suddenly find it hard to walk, get medical help right away. 

Although extremely rare, other signs to be aware of that are considered “red flags” include¹:

• A recent serious injury
• History of rheumatoid arthritis
• Symptoms of infection (such as a fever)
• History of cancer
• Use of IV drugs or steroids
• Ripping/tearing sensation

What causes a whiplash injury?

Understanding the cause of your whiplash injury can help guide treatment options and promote long-term relief. Neck strains can result from various causes, with some more common than others. 

Here’s a look at the typical causes of a whiplash injury and how they may impact your body:

1. Collisions and falls: A collision or fall can place the neck under sudden strain, especially when unexpected. This kind of forceful movement is often seen in car accidents, where the force of the rapid back-and-forth movement places the neck under stress. The most common cause is motor vehicle accidents. For example, of all the claims lodged to the Motor Accidents Authority (MAA) since 2007, almost half of claimants had a whiplash-associated disorders as one of their reported injuries². Studies indicate that nearly 50% of individuals continue to experience some symptoms up to a year post-accident, demonstrating how impactful and persistent these injuries can be³.
2. Sports: Certain contact sports may provoke a whiplash injury particularly with heavy contact during movement such as tackling. These kinds of injuries, also referred to as an acceleration-deceleration trauma, can result in concussion and other symptoms and commonly occur in football, soccer, and basketball⁴. 

Neck pain can also be a result of poor posture, tensions from stress or repetitive/unbalanced movements and heavy lifting. 

How is a whiplash injury diagnosed?

Diagnosis and early treatment can make a significant difference, so it’s better to address a whiplash injury sooner rather than later.

There are a few steps involved in a whiplash diagnosis that allow healthcare providers to rule out more severe conditions and identify the best treatment options:

1. Medical history and symptoms: Your healthcare provider will start with a detailed medical history and ask questions about your symptoms, recent injuries, and daily habits. Depending on the cause of your whiplash injury, they may also do some screening for post traumatic stress. 
2. Physical examination: This examination typically includes assessing the range of motion in the neck including head position and posture, feeling for any tenderness, and checking for signs of nerve involvement, such as weakness or numbness.
3. Imaging tests: Your doctor may ask questions to determine the level of risk associated with symptoms before deciding if imaging is required. The Canadian C-Spine Rule was developed to determine who needs imaging based on a rule using three high-risk criteria, five low-risk criteria, and the ability of patients to rotate their necks⁵. In more complex cases, imaging tests such as X-rays, CT scans, or MRIs may be used to rule out fractures, herniated discs, or other structural problems but only in cases that meet highest severity scales. It is also important to remember that an xray does not provide information about pain levels, however can provide reassurance there is no serious bone damage. 
4. Severity assessment with the QLWAD Scale: The Quebec Task Force on Whiplash-Associated Disorders (QLWAD) scale grades the severity of whiplash classification including a rating from 0 (no symptoms) to IV (neck complaint and fracture/dislocation)⁶. This scale can help determine whether conservative care or a more targeted treatment approach is needed.

It is important to remember that every whiplash injury is different and can largely depend on the person's situation, history and background. 

How long is the recovery from a whiplash injury?

Most people recover from a whiplash injury especially with proper treatment and rest. Research suggests that about half of people with WAD recover within three to six months of their injury⁷. However, if symptoms persist beyond six weeks, there may be underlying factors at play, such as central sensitization, where the nervous system becomes more sensitive to pain signals. Persistent symptoms may also involve biopsychosocial (BPS) factors, where physical, psychological, and social influences all contribute to the intensity and persistence of pain. In addition, there are certain risk factors involved in how well someone might recover. So, let's talk about the prognosis…

Is whiplash injury serious? A prognosis

While neck pain more broadly is varied and complex, there has been a lot of research and data collected over the years particularly for those people experiencing a whiplash injury after a motor vehicle accident. It has been suggested that around half of people who experience whiplash recover fully within 3-6 months. 

So you might be wondering, what about the other half? 

This is when a person’s whiplash injury recovery is complicated by higher risk factors for delayed recovery including⁸:

• High initial pain levels (e.g. above 5.5/10 self reported rating)
• High disability levels - based on a score of the Neck Disability Index (> 29%) which is a self-reported survey asking questions about how much the neck strain is impacting on your ability to perform daily activities - with greatest disability at a score of 50/50). 
• Symptoms of post traumatic stress⁹
• Negative expectations of recovery 
• High levels of pain catastrophising
• Cold hyperalgesia (an increased sensitivity to painful cold stimuli)

Early identification of people with a neck strain that are in these higher risk categories and providing personalized care will improve whiplash recovery and reduce treatment costs¹⁰.

Whiplash injuries are extremely individual but there can be additional complications when compensation and legal factors are involved…and if the injury occurred from a motor vehicle accident, this can often be the case. While the evidence linking whiplash injury prognosis and the compensation process is not conclusive¹¹, for some people, the stress involved in filling out paperwork, dealing with the medical and legal systems can be stressful; and we know how stress and anxiety can impact our pain system. In addition, the economic burden of treatment for whiplash injury is significant and this is multiplied many times when including the cost of litigation¹². 

A person's experience of a whiplash injury is unique with a range of factors (physical, psychological, and social) that influence each other¹³¹⁴. There is no right or wrong way and everyone's experience will be different. Regardless, it is important to understand that pain is real and seeking informed, multidisciplinary support is important. 

Whiplash injury treatments

With timely and appropriate treatment, a whiplash injury often heals gradually - particularly when treatment is targeted to the individual based on their risk category.

Completing the Whiplash Assessment Questionnaire (WhipPredict) can help guide your recovery after whiplash and identify if you might be more at risk of developing chronic pain. 

 Here are some common approaches, along with the evidence supporting their effectiveness. 

1. Education and advice: A first line treatment for someone experiencing a whiplash injury who is considered a low risk is education. Be reassured that you can remain active and it is important to stay positive and understand typical recovery times for whiplash. When education around what to expect from a whiplash injury is delivered in simple, non-threatening language, it can help a person feel at ease and avoid slipping into catastrophization. It has been shown that patients expectations about getting better are as important as their physical symptoms¹⁵. A basic whiplash factsheet, like this one, can be a helpful place to start or this Whiplash injury recovery self-help guide.
2. Medication: Australian WAD management guidelines recommends over-the-counter pain relievers and non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain and reduce inflammation¹⁶. In cases of severe pain, your doctor may suggest stronger medications. 
3. Stay active including working: Research shows that staying active and continuing with your daily activities as much as possible aids in recovery provided strategies are in place to handle work demands incorporating emotional, practical or financial support¹⁷. 
4. Heat and cold therapy: Cold therapy can reduce inflammation, while heat therapy can relax tense muscles. Many people find alternating between the two to be helpful. While these are generalised approaches to muscle strains - and may only be effective for short periods, and in conjunction with other evidence based treatments. 
5. Physical therapy: Specific neck exercises can improve neck strength and flexibility, promoting healing and preventing future strain. Evidence supports the effectiveness of tailored physical therapy exercises¹⁸, especially when combined with other therapies. Specific whiplash recovery exercises are effective and easily available such as via NSW State Insurance Regulatory Authority. 
6. Psychological support: Research suggests that injury-related pain can lead to psychological effects, such as anxiety or post-traumatic stress disorder (PTSD). Treatments like cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) can address these aspects and may improve overall pain outcomes​​. Coping strategies around self compassion, targeted strategies for managing stress and helpful self talk can also be really useful. 
7. Biopsychosocial approach: The BPS model is increasingly recommended for treating chronic pain. It combines education, exercise, psychological support (including CBT and ACT), diet, and medication as part of a comprehensive pain management plan. This approach treats not only physical symptoms but also addresses the mental and social aspects of chronic pain​​.

A comprehensive examination of WAD incorporating the published evidence based recommendations for the management of whiplash is available from the Motor Accidents Authority¹⁹.  

What about cervical collars?

While you may have seen neck collars in movies (Julia Roberts in Erin Brockovich comes to mind), immobilization is generally not recommended for whiplash²⁰. In fact, evidence suggests that keeping the neck mobile (as advised by a healthcare provider) leads to better outcomes than prolonged immobilization.

Preventing whiplash injury

Prevention can go a long way in reducing your chances of experiencing neck strain. Here are some strategies to keep in mind:

• Car safety: When driving, ensure your seat is properly adjusted, wear a seatbelt, and practice safe driving habits. Correct seat position including the location of the headrest can help minimize the risk of whiplash in case of a collision.
• Sports safety: Be aware of the possibility of dangerous contact during sports. Building neck strength through targeted exercise can be helpful as can the use of approved in-game protective gear. 
• Posture: Be mindful of your posture, especially during screen time or activities that require extended use of your hands or arms. Ergonomic adjustments, such as placing your computer screen at eye level, can help.
• General health: Regular exercise and stretching can keep your neck muscles strong and flexible, which may reduce your risk of strain.

Support for whiplash injury...

If you have acquired a whiplash injury as a result of a motor vehicle accident, your insurance case manager or relevant transport regulatory authority will be available to assist in co-ordinating your care, appointments and recovery. 

If you’re looking for science-backed support to help with whiplash or neck pain, we’re here to help. MoreGoodDays® offers a program designed to reduce pain and help you get back to living—all from the comfort of home. With guidance from leading experts, we provide clear, non-drug tools that can truly make a difference in managing and recovering from back pain.

Our whole-person approach is grounded in the latest scientific evidence, focusing on the root causes of ongoing back pain to help you find lasting relief.

Take the first step toward managing your pain by learning more about our Back Pain Program today.