Whiplash Treatment Overview

When to see a healthcare provider

You should always see a healthcare provider if you have whiplash. They will rule out damage to your spinal cord or other injuries. If whiplash is severe, your provider will check for signs of nerve damage and fractures. Whiplash often improves over several weeks, although some may have symptoms for up to 12 months or longer.

Getting diagnosed

Whiplash can be diagnosed based on how you were injured, your symptoms, and a physical exam. Imaging tests may be ordered to rule out a brain injury and to check for damage or inflammation of the nerves, soft tissue, and spine. These tests may include X-rays, MRI, or CT scan.

What to expect from your doctor visit

• If you have muscle stiffness, your provider may prescribe a muscle relaxant. This can make you sleepy, so you may want to take it at night.
• Pain-relieving patches like diclofenac (Flector) may help some people.
• A nerve block can relieve severe or chronic pain from whiplash. Nerve blocks are injections of medications that block pain from specific nerves.
• Trigger point injections, which are injections of a pain-relieving medication (lidocaine) into the muscles of the neck and upper back, may relieve pain.
• If you have chronic pain from whiplash, antidepressants may help reduce pain and mood symptoms that sometimes occur with prolonged pain. Tricyclics, like amitriptyline (Elavil) and nortriptyline (Pamelor), are the most common type of antidepressant prescribed to treat pain. Other types include SSRIs like paroxetine (Paxil) and SNRIs like venlafaxine (Effexor XR).
• For chronic whiplash, there is a procedure called cervical radiofrequency neurotomy. It temporarily quiets the nerves that cause whiplash pain.

Your provider may recommend therapies based on your symptoms.

• Physical therapy can help reduce pain and strengthen muscles.
• Occupational therapy can help you get back to doing daily activities.
• Neuropsychological therapy can help with symptoms like difficulty thinking and concentrating.
• Osteopathic manipulative medicine (OMM) is when specially trained physicians relieve pain by adjusting your neck with their hands.

Prescription whiplash medications

• Baclofen (Gablofen), cyclobenzaprine (Flexeril), methocarbamol (Robaxin)
• SSRIs: paroxetine (Paxil), fluoxetine (Prozac)
• SNRIs: venlafaxine (Effexor XR), duloxetine (Cymbalta), desvenlafaxine (Pristiq)
• Tricyclic antidepressants: amitriptyline (Elavil), nortriptyline (Pamelor)

Types of providers who treat whiplash

• A primary care provider can treat mild to moderate whiplash.
• For severe or complicated cases of whiplash, you may be referred to an orthopedic physician, a specialist who treats conditions of the musculoskeletal system.

Treating whiplash at home

Always see a healthcare provider if you have signs of whiplash, which include dizziness, ringing in the ears, numbness in the hands or arms, and pain and stiffness in the neck, shoulders, and upper back. It is important for a provider to rule out damage to your spinal cord or other injuries.

Depending on their severity, symptoms can be relieved by making lifestyle changes and taking OTC pain medication like ibuprofen or acetaminophen. Neck and head pain usually goes away within a few days or weeks.

OTC medications

• Acetaminophen (Tylenol)
• Ibuprofen (Advil, Motrin)
• Naproxen (Aleve)

Tips for treating whiplash

• Apply ice to the painful areas for 20 minutes, three to five times a day to reduce inflammation.
• Topical analgesics: Pain-relieving patches may help some people when other treatments are not working.
• The first day after the injury you should avoid moving the neck.
• After 24 hours, you can gently move your neck, which may speed up recovery. Getting back to doing normal activity is typically the goal in mild and moderate whiplash injuries. Your provider may also recommend stretching exercises.
• Wearing a soft neck collar restricts neck motion and prevents further injury. Though studies have shown they may slow your recovery. Discuss the need for a neck collar with your provider, including how many hours per day and how many days you should wear one.
• Practice good sleep hygiene to improve the quality of your rest. Poor sleep can worsen chronic pain.