Cervical whiplash is a neck injury due to forceful, rapid back-and-forth movement of the neck. It is commonly seen in low speed, rear-end motor vehicle collisions. This results in either neck strain or sprain. Strains are injuries of the musculature caused by stretching and tearing of the muscle fibers whereas sprains are injuries of the ligaments resulting from stretching or tearing of the ligamentous tissue.
Symptoms may include localized neck pain with decreased range of motion and tightness in the neck. On examination, an individual may have spasm of the posterior cervical muscles. Sometimes the pain may be immediate or in other cases it may take hours or several days to develop. Most cases resolve in several days, however more intense strains or sprains may take several weeks to resolve.
Treatment includes the use of ice packs, moist heat therapy, or immobilization with a soft cervical collar. Medications may be used and include acetaminophen, nonsteroidal inflammatory drugs, muscle relaxant medication, or judicious use of narcotic medication. Once the acute phase has passed, the use of physical therapy with stretching exercises or massage therapy may be instituted.
Within the automobile industry, the instillation of seatbelts, airbags, and head restraint systems have greatly reduced the severity of this type of injury. Several industry and medical studies have evaluated the severity of this injury in relation to the velocity of the force developed in a rear-ended collision. A comprehensive review of low-speed rear impacts concluded that the risk of injury beyond neck strain in rear impacts at less than 18 kph (10.8 mph) is essentially zero. (“A Comprehensive Review of Low-Speed Rear Impact Volunteer Studies and a Comparison to Real-World Outcomes,” Spine 2018; 43:1250-1258.)