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Spokane, Washington  Est. May 19, 1883
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Non-drug therapy helps whiplash

Anthony L. Komaroff M.D.

DEAR DOCTOR K: I was in a car accident several months ago and got whiplash. I still have neck pain. Is this normal?

DEAR READER: The neck contains vertebrae with joints between them. The bones are attached to muscles and ligaments that hold them together, and that hold the neck upright, allowing it to move as your head moves.

Whiplash – the term used to describe a group of symptoms and also the typical accident that leads to them – can damage one or more of these delicate structures.

We used to think that the initial impact of whiplash jerked the head and neck back and then forward. Now we know there is a critical moment or two before that back-and-forth. When your car is hit from behind, your torso is pushed forward while your chin is forced down. Seen from the side, your neck momentarily looks like an S, as the upper and lower areas are unnaturally forced in different directions.

Researchers now believe that this “S phase” of whiplash is when injury is most likely to occur, as the muscles, ligaments and joints strain to hold the vertebrae.

Whiplash symptoms include stiffness, neck and shoulder pain; muscle spasms in the neck or upper shoulders; decreased range of motion; and tingling or weakness in the arms.

If you haven’t already, begin gentle range-of-motion exercises and then neck-strengthening exercises with guidance from a physical therapist. Strong neck muscles decrease the stress on other muscles, disks and vertebrae. This gives damaged tissue a chance to heal.

Various pills are sometimes prescribed – tricyclic and SSRI medicines, gabapentin – but their benefits are limited. The muscle-relaxing treatment called Botox also has been unsuccessfully tried.

Facet joint injections may also help by numbing pain and reducing inflammation.

If your symptoms continue after a few months, talk with your doctor. On very rare occasions, surgery may be a corrective option. But most people recover from whiplash through physical therapy and regular exercise.

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