Neck
Whiplash
Whiplash is an injury to the soft tissues of the neck caused by rapid forced movement of the head, most commonly in a rear-end vehicle collision. The muscles, ligaments, joints and discs of the cervical spine are loaded beyond their normal range within a fraction of a second. Symptoms characteristically begin some hours or days after the event rather than immediately, which is a normal feature of the injury and not an indication that it is minor.
Symptoms
Onset is typically delayed. The absence of pain immediately after a collision does not establish that no injury occurred.
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Neck pain and stiffness
Often worse on the second or third day than on the first, and frequently worse in the morning. Loss of rotation is usually noticed before loss of any other movement.
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Headache
Commonly beginning at the base of the skull and radiating forward. Headache arising after a collision is assessed rather than assumed to be ordinary.
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Symptoms in the arm
Numbness, tingling or weakness travelling into an arm suggests involvement of a nerve root and is examined directly rather than attributed to muscle injury.
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Associated symptoms
Dizziness, disturbed sleep, difficulty concentrating, jaw pain and fatigue are reported. Where there has been a head impact, these may also relate to concussion and are assessed on that basis.
Assessment
Whiplash is a clinical diagnosis. Imaging is used to exclude other injuries rather than to demonstrate the soft-tissue injury itself, which does not appear on plain films.
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History and examination
The mechanism of the collision, the time symptoms began, range of movement, tenderness, and a neurological examination of both arms.
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Imaging where indicated
Validated clinical criteria guide whether X-ray or CT is needed to exclude fracture. MRI or ultrasound may be used where soft-tissue or disc injury is suspected.
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Electrodiagnostic testing
Where arm symptoms persist, nerve conduction studies and electromyography can establish whether a nerve is affected and at what level.
Common questions
Why did the pain start a day later?
Delayed onset is characteristic. The inflammatory response to soft-tissue injury develops over hours, and the effects of adrenaline and attention at the time of a collision mask symptoms that emerge once both subside.
Does a low-speed collision cause whiplash?
It can. The injury depends on the acceleration transmitted to the head and on factors such as head position and headrest height, which is why the extent of vehicle damage is an unreliable guide to whether a person was injured.
How long does recovery take?
Most people improve over several weeks to a few months. A minority experience symptoms that persist longer, which is why symptoms that are not settling are reassessed rather than waited out indefinitely.
Should a collar be worn?
Generally not for prolonged periods. Current guidance favours early gentle movement, as extended immobilisation is associated with stiffness and slower recovery. A collar may be used briefly in specific circumstances on medical advice.
General reference information, and not advice about your own case. It may not reflect the most recent guidance or what is offered on a given day — call (201) 408-5151 to check.
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