QUESTION

I was just rear-ended again—this makes the third time I’ve had whiplash—and I seem to feel worse each time. Is that my imagination?

ANSWER

Usually, whiplash symptoms resolve on their own within a few weeks or months. But for about one-third of people who get whiplash, it can be a long-term—even debilitating—disorder that never completely goes away. This is more likely to happen with repeated whiplash, especially when whiplash happens again before full recovery from the previous injury. Whiplash is the term for neck injury caused by quick, forceful back-and-forth snapping of the neck—typically from being in an auto accident, but you can also get whiplash from any kind of accident, physical abuse or trauma. Symptoms can include neck pain, neck and shoulder stiffness, headache and tingling and numbness in the arms. It’s also common to feel dizzy and to have trouble sleeping. Getting whiplash multiple times can cause changes in your autonomic nervous system that can make you more sensitive to pain anywhere in your body and cause changes to blood pressure and abnormal sweating. Trauma to the nervous system can also cause postural muscle weakness and weakness to the limbs, usually on one side of the body. Repeated whiplash can also cause benign paroxysmal positional vertigo, a condition in which sudden movement causes a sensation of spinning or that the world around you is spinning. And the stress of chronic pain can lead to anxiety and depression.

HOW TO RECOVER FROM WHIPLASH

Generally, it’s best to start treatment as soon after injury as possible. There is no one-size-fits-all therapy, but whether you’re treating your first episode of whiplash or your second (or third or fourth), these therapies can help…
  • Ice within the first 72 hours of initial injury to reduce pain and swelling…after 72 hours, heat to improve circulation, improve motion and reduce pain.
  • Over-the-counter pain medications such as ibuprofen (Motrin) or acetaminophen (Tylenol).
  • Gentle, assisted spinal manipulation from a chiropractor.
  • Physical therapy.
All of these potential treatments should be managed by a physician who examines you and tracks your progress—don’t treat whiplash yourself. What about those soft neck collars that are what many people think of when they imagine whiplash treatment? Your doctor may recommend that you wear one if an MRI shows ligament damage and/or there is significant pain both with movement and at rest. It’s generally best to wear a neck collar immediately after the injury for up to seven days to prevent excessive movement while the muscles and soft tissues heal enough to receive therapy. Wearing a neck collar longer immobilizes neck muscles, which can cause them to become stiff and weak. In fact, moving your neck and staying active is important for full recovery. But do avoid activities that have a greater-than-average chance of leading to another neck injury. If dizziness persists, the cause needs to be determined. Neck trauma can cause orthostatic hypotension, a drop in blood pressure when rising from lying down or sitting that causes dizziness. Pain or other symptoms that last longer than a day or two should be checked by a medical or chiropractic neurologist to see if there is nerve damage. Since inflammation is a big part of neck pain and other whiplash symptoms, an anti-inflammatory diet including lots of vegetables and fruit and omega-3 fatty acids from such foods as nuts, seeds and cold-water fatty fish can be very helpful.