Whiplash needs gentle exercise, medication

DEAR DOCTOR K: Several months ago, a car rear-ended me and I ended up with whiplash. My neck still hurts. What can I do?

DEAR READER: The force of a rear-end collision momentarily jerks your neck into an unnatural position. This can badly strain your neck muscles and can stretch or tear the ligaments in your neck. The bones of the spine in your neck, particularly the facet joints where one bone meets another, can be damaged. The nerves that leave your neck through holes in the spinal bones also may be affected.

Whiplash usually results in neck pain. It may also cause shoulder pain, muscle spasms, stiffness and a decreased range of motion.

Early on, you probably used ice packs and over-the-counter NSAIDs such as ibuprofen (Advil) or naproxen (Aleve) to relieve pain and inflammation.

Now you have to begin the slow process of helping your neck heal. It is fine for most people to use an over-the-counter pain medicine, particularly acetaminophen, to help ease the pain. Also, a muscle-relaxing medicine like cyclobenzaprine, taken at bedtime, can be helpful.

If you haven’t already, talk with your doctor or a physical therapist about gentle range-of-motion exercises and then isometric neck-strengthening exercises. Strong neck muscles will help maintain proper head and neck posture. This decreases the stress on muscles, disks and vertebrae. It gives damaged tissue the opportunity to mend.

Massage therapy may also help promote healing. Massage relieves muscle tension and spasms, loosens stiff joints and promotes relaxation.

Surgery is rarely used to treat whiplash, but it may be done if you continue to experience severe pain or disability after trying nonsurgical treatments.