Brain & Nervous System Headaches What Is Whiplash? By Colleen Doherty, MD Colleen Doherty, MD Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis. Learn about our editorial process Updated on April 17, 2020 Medically reviewed by Nicholas R. Metrus, MD Medically reviewed by Nicholas R. Metrus, MD LinkedIn Nicholas R. Metrus, MD, is board-certified in neurology and neuro-oncology. He currently works at the Glasser Brain Tumor Center with Atlantic Health System in Summit, New Jersey. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Symptoms Causes Diagnosis Treatment Whiplash is a neck injury caused by a forceful back-and-forth motion of the neck. It commonly occurs in a rear-end car collision, when there is a sudden and intense accelerating and/or decelerating motion of the neck causing it to flex and/or extend rapidly. Whiplash causes a strain or sprain of the neck muscles and/or ligaments, but it can also affect the vertebrae (the 7 bones in your neck), discs (the cushion between your vertebrae), or the nerves in your neck. If you experience a headache that starts at the base of the skull following an auto accident, it is likely a whiplash headache. Symptoms Whiplash symptoms tend to come on several hours to a few days after the incident and typically worsen in the days after injury. Symptoms may last a few weeks to a few months, and may severely limit activity and range of motion. Signs of whiplash may include: Numbness and tingling sensations (called paresthesias or pins and needles) in fingers, hands, or arms Limited range of motion in the neck Neck stiffness Muscle spasms Dizziness Headaches Pain that extends into the shoulders and back Cognitive impairment like memory problems or difficulty concentrating Fatigue Blurred vision Ringing in the ears (tinnitus) Sleep disturbances Irritability Depression A whiplash headache tends to start at the base of the skull and can vary in intensity. Most people experience pain on one side of the head and toward the back, though some people get symptoms all over their head, and a small number of patients experience a whiplash-related headache on the forehead or behind the eyes. Whiplash headaches are often aggravated by neck movements, particularly when looking up. These headaches are often associated with shoulder pain and touching the trapezius muscles on the back of the neck and shoulders can increase the pain. Whiplash headaches can lead to chronic neck-related headaches known as a cervicogenic headache. Causes Whiplash occurs when your head is forcefully and quickly thrown backward and then forward. This motion can injure bones and soft tissue in the spine and neck. The most common cause of whiplash is a rear-end auto collision. However, whiplash can also occur due to: physical assault, such as being punched or shakenplaying contact sports, such as a tackle in footballa slip and fall where the head is suddenly jolted backward and forwardbeing struck on the head by a solid or heavy object Diagnosis Most of the time whiplash and its symptoms, like headache, are easily diagnosed and resolve on their own. If you have any concerns, or if symptoms are worsening or persisting for more than 2 to 3 weeks, you experiencing numbness and/or muscle weakness in your arms and/or legs, or your symptoms are severe enough to interfere with your daily functioning, see your healthcare provider right away. In order to be diagnosed with a whiplash headache, you must have experienced a form of whiplash injury and developed the headache within seven days after that injury. Your healthcare provider will ask you questions, examine you, and possibly order an X-ray of your neck to check for a fracture, a CT (computed tomography) scans or an MRI to more closely evaluate the injury, especially if you are having neurological symptoms like numbness. The healthcare provider may also rule out other causes of headaches, such as post-traumatic subdural hematoma If your injury persists for more than 3 months after the whiplash injury, it's termed a persistent headache attributed to whiplash. At this point, your healthcare provider may also consider a medication overuse headache, as you may be taking medications for your headache that may cause rebound head pain. Treatment Symptoms from a whiplash injury usually resolve within 2 to 3 weeks. In the first few days after the injury, icing the neck for 10 minutes several times a day can help reduce pain and inflammation. It is also important to rest your neck area following the injury. While cervical collars were once the go-to treatment for whiplash, healthcare providers now say it is better for longterm recovery to keep the area mobile If you have a whiplash-related headache, you should reduce physical activity and not engage in contact sports until you can look over both shoulders, rock your head all the way forward, all the way back, and from side to side without pain or stiffness. Additional treatments may include: Non-steroidal anti-inflammatories (NSAIDs) like Ibuprofen (Advil, Motrin) or Naproxen (Aleve)Muscle relaxers like Flexeril (cyclobenzaprine)Moist heat, after the initial swelling has gone downUltrasoundMassageChiropracticElectronic nerve stimulationAcupunctureStretchingMaintaining good posture (i.e. sitting up straight with your shoulders back)Avoiding carrying bags on your shouldersSleeping in a healthy position (i.e. sleeping on your back with a pillow under your thighs) If your symptoms do not improve with these conservative measures, your healthcare provider may recommend physical therapy and/or stronger pain medications. If a whiplash headache lasts for several months, physical therapy, acupuncture, or spinal injections may be considered. A Word From Verywell Whiplash commonly causes a headache, as well as other symptoms, like neck stiffness, fatigue, and shoulder/neck/back discomfort. If you experience whiplash, talk to your healthcare provider for recommendations for over-the-counter remedies. If symptoms do not improve or continue to worsen after 2 to 3 weeks, see your healthcare provider or chiropractor for further evaluation and treatment. 3 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Institute of Neurological Disorders and Stroke. Whiplash Information Page. Drottning M. Cervicogenic headache after whiplash injury. Curr Pain Headache Rep. 2003;7(5):384-6. doi:10.1007/s11916-003-0038-9 Page P. Cervicogenic headaches: an evidence-led approach to clinical management. Int J Sports Phys Ther.; 6(3):254–266. By Colleen Doherty, MD Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis. 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