Whiplash is a neck injury caused by sudden and forceful back-and-forth movement of the neck. It is the most common injury perceived during a car accident however other types of trauma like fall from height, sports injuries, and physical abuse can also result in whiplash injury.

The medical term used for whiplash injury is Whiplash Associated Disorder. Sometimes, whiplash is also called neck sprain or strain, but these terms also include other types of neck injuries.

Signs and Symptoms:

Signs and symptoms of whiplash usually develop a few days after the event which caused the injury and require time to heal, depending upon the severity of the trauma. Common signs and symptoms of whiplash injury include the following:

• Neck pain and stiffness
• Decreased or total loss of neck movements
• Headache
• Exacerbation of pain during neck movements
• Partial or complete sensory loss in the hands and arms
• Numbness and Tingling in the hands and arms
• Pain in the shoulder, arms, and upper back
• Fatigue and dizziness (Tameem et al., 2013)

Treatment:
The patient with whiplash injury usually presents in the emergency department, and the main goal of treatment at that time is relieving the patient’s pain. After the pain is relieved, the definite treatment goals include the following:

• Restoration of the normal range of motion of your neck
• Promoting healing
• Preventing flare-ups
• Getting you back to your routine activities.

The approach and treatment plan depends on the severity of the trauma. Some patients only need over-the-counter medications for pain relief. Others require prescription medications, physical therapy, specialized treatment plans, and follow-ups. (Yadla et al., 2007)

Pain management
Your doctor will prescribe the following measures and medications to relieve the pain and prevent flare-ups:

• Bed rest for a few days, however, it should be noted that too much bed rest may prolong recovery time
• Heat or cold packs applied to your neck 4-6 times daily to relieve pain and tenderness
• Over-the-counter pain reliever drugs such as acetaminophen and ibuprofen for mild to moderate pain
• Prescription medications, such as opioids and antidepressants for severe or neuropathic pain.
• Muscle relaxants such as tizanidine or orphenadrine for loosening of tight muscles and soothing pain
• Local injections such as Xylocaine for relieving pain when injected into the affected muscle. (Yadla et al., 2007)

Exercise and Physical Therapy:
Your doctor will recommend movement and stretching exercises to do at home in order to restore the range of motion of your neck and promote healing. In addition to these exercises, a warm shower or steam applied to your neck can also help decrease recovery time. The series of exercises that are helpful after whiplash injury include the following:

• Rotating your neck in both directions
• Twisting your neck toward your chest
• Bending your head side to side
• Shoulder rolling

In case your prolonged, your doctor may refer you to a physical therapist to assist you in effectively doing various exercises. Physical therapy can help you recover and prevent further damage. Physical therapy also helps to improve posture, strengthen muscles, and restore normal functions.

In severe and non-responsive cases, transcutaneous electrical nerve stimulation (TENS) can help in easing pain and improve functions. Your physical therapist will prescribe a specific number of sessions depending on the degree of trauma perceived to your neck. (Haiduk et al., 2017)

Immobilization Techniques:
The use of foam collars for whiplash injury has limited clinical significance because holding the neck in one position for a long time can decrease muscle power and make your neck stiff. However, foam collars are still used to reduce pain associated with movement after an injury or during nighttime for better sleep. Most physical therapists and doctors allow foam collars to be applied for less than 72 hours. Before using a foam collar, you should consult your physical therapist. (Barati et al., 2017)

Alternative Medicine:
Nontraditional treatments have been used for treating whiplash injuries, but research about their clinical efficacy is limited. Some of the common non-traditional treatments for whiplash injuries include the following:

• Acupuncture:
  Acupuncture techniques have long been used for whiplash injuries and still have comparable clinical usage in the United States. Acupuncture involves inserting fine needles into the specific areas of your skin that helps to relieve pain and stiffness associated with injury.
• Chiropractic care:
  Chiropractic techniques for joint maneuvering can prove efficacious if performed by an expert. According to research, chiropractic techniques can increase pain relief when used in combination with physical therapy and exercises. Manipulating spine joints can cause minor problems in rare cases which may include dizziness and numbness.
• Massage:
  Massage can provide temporary relief from the symptoms of a whiplash injury, but it has no efficacy in definitive or long-term treatment.
• Mind-body therapies:
  These therapies include exercises involving focused breathing and mindfulness that are combined with gentle movements to help ease pain and stiffness as well as stress and depression associated with the illness. Common examples of mind-body techniques include tai chi, yoga, and qi gong. (Anderson et al., 2018)