The goals of treatment are to control pain, restore normal range of motion in your neck and return you to normal activities. The course of treatment will vary depending on the severity of your whiplash injury. For some people, over-the-counter drugs and at-home care may be sufficient. Other people may need prescription drugs, specialized pain treatment or physical therapy.
Your doctor may recommend one or more of the following treatments to lessen pain:
- Rest. Rest may be helpful during the first 24 hours after injury, but prolonged bed rest may delay recovery.
- Ice or heat. Apply ice or heat to the neck for 15 minutes up to six times a day.
- Over-the-counter pain medications. Over-the-counter pain relievers, such as acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin IB, others), often can control mild to moderate whiplash pain.
- Prescription painkillers. People with more-severe pain may benefit from short-term treatment with prescription pain relievers.
- Muscle relaxants. These drugs may control pain and help restore normal sleep if pain prevents you from sleeping well at night.
- Injections. An injection of lidocaine (Xylocaine) — a numbing medicine — into painful muscle areas may be used to decrease pain so that you can do physical therapy.
Your doctor will likely prescribe a series of stretching and movement exercises to help restore range of motion in your neck and enable you to resume normal activities. You may be advised to apply moist heat or to take a warm shower before exercise. Exercises may include:
- Rotating your neck in both directions
- Tilting your head side to side
- Bending your neck toward your chest
- Rolling your shoulders
Your doctor may refer you to a physical therapist if you need help learning range-of-motion exercises or if you experience chronic pain from whiplash. The therapist may introduce additional exercises to strengthen muscles, improve posture and restore normal movement. The goal is to create a customized routine that eventually you can do independently at home.
Soft foam cervical collars were once commonly used for whiplash injuries to hold the neck and head still. However, studies have shown that immobilizing the neck for long periods of time can decrease muscle strength and impair recovery.
Recommendations for the use of a collar vary, but use is generally restricted to no more than three hours at a time during the first week after injury, when you are experiencing more-severe pain. Your doctor may also recommend use of a collar if it helps you sleep at night.
Jan. 20, 2015
- Ferri FF. Ferri's Clinical Advisor 2015: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2015. http://www.clinicalkey.com. Accessed Oct. 16, 2014.
- Frontera WR, et al. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.clinicalkey.com. Accessed Oct. 21, 2014.
- NINDS whiplash information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/whiplash/whiplash.htm. Accessed Oct. 18, 2014.
- Bannister G, et al. Whiplash injury. The Journal of Bone and Joint Surgery. 2009;91:845.
- Isaac Z, et al. Evaluation of the patient with neck pain and cervical spine disorders. http://www.uptodate.com/home. Accessed Oct. 14, 2014.
- MacDermid JC, et al. Measurement properties of the neck disability index: A systematic review. The Journal of Orthopaedic and Sports Physical Therapy. 2009;39:400.
- Yadla S, et al. Whiplash: Diagnosis, treatment, and associated injuries. Current Reviews in Musculoskeletal Medicine. 2008;1:65.
- South-Paul JE, et al. Current Diagnosis & Treatment in Family Medicine. 3rd ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://accessmedicine.mhmedical.com/book.aspx?bookId=377. Accessed Oct. 22, 2014.
- Anderson BC, et al. Treatment of neck pain. http://www.uptodate.com/home. Accessed Oct. 14. 2014.
- Shekelle P, et al. Spinal manipulation in the treatment of musculoskeletal pain. http://uptodate.com/home. Accessed Oct. 21, 2014.