Treatment focuses on alleviating pain and stiffness in the neck, as well as healing the damage to muscles, ligaments and tendons.
Most patients will experience a significant improvement in symptoms after a few days. According to the NHS (National Health Service), UK, in approximately 60% of cases symptoms clear up completely within one to four weeks. Some people still have symptoms several months after the injury occurred; on rare occasions problems may persist for even longer.
The following treatment may help alleviate symptoms:
- Ice-pack – applying an ice-pack immediately after the injury occurs, or as soon as possible, helps reduce swelling (inflammation). Wrap the ice in a towel or some protective barrier – do not apply ice directly to the skin. An ice-pack session should last from 10 to 30 minutes.
- Exercise – patients should try to move their necks normally; it is important to do this under the directions of a doctor, physical therapist (UK: physiotherapist) or qualified health care professional. In cases where symptoms are severe, the individual may have to completely rest the neck until the pain allows for movement.
- Pain – painkillers, such as Tylenol (paracetamol) should help reduce whiplash injury pain. Some doctors may advise patients to take painkillers regularly, and not just when the pain is severe. It is important not to exceed the dose.
NSAIDs (non-steroidal anti-inflammatory drugs), such as ibuprofen may help with the swelling (inflammation). Patients with asthma, hypertension (high blood pressure), kidney failure or heart failure should check with their doctors, because in most cases they should not take NSAIDs.
If pain is more severe the doctor may prescribe codeine, or some other stronger painkiller. Sometimes codeine with Tylenol (parecetamol) are prescribed together.
- Posture – a qualified health care professional should teach the patient how to maintain an upright good posture, for example, keeping the back straight when walking, standing or sitting, as this can prevent neck pain and stiffness from getting worse. A firm pillow may help maintain good posture while sleeping.
- Injections – corticosteroid or lidocaine injections may help relieve muscle spasms.
- Muscle relaxants – these may help ease muscle spasms. As muscle relaxants may cause drowsiness, most doctors advise their patients to take them at bedtime.
- Physical therapy (UK: physiotherapy) - a physical therapist may use massage and manipulation, as well as recommending neck exercises. The physical therapist may also use ice, heat and/or ultrasound.
- Osteopathy – in Western Europe osteopathy is commonly used to treat whiplash. Osteopathy uses manipulation to treat back, neck, and sports injuries.
- Collars – soft foam collars used to be popular for whiplash injury treatment. However, immobilizing the neck for long periods may undermine recovery, because muscle bulk and strength is reduced. If a cervical collar is needed, it should usually be worn for more than three hours at a time. For some patients who keep waking up with whiplash pain, a collar may help get a good night’s sleep.
When pain levels allow, the patient should exercise the neck gently so that it does not stiffen up. The neck should be moved slowly in each direction, gradually widening the range.