Whiplash-associated disorders (WAD) refer to a group of symptoms that can arise after the rapid acceleration and deceleration of the head and neck—most commonly during rear-end automobile collisions. Of the many whiplash symptoms, neck pain is the most frequently reported. However, the neck is a complex structure composed of various components that can be affected by whiplash forces. Let’s examine the potential pain generators in whiplash-related neck injuries.

• The spinal cord is the central communication highway between the brain and the rest of the body. It travels through the vertebral canal, with nerve roots branching off at each level to transmit motor and sensory signals. Direct injury to the spinal cord or nerve roots is uncommon in most whiplash cases. However, inflammation or compression of surrounding tissues can irritate the nerve roots, leading to localized or referred pain, tingling, numbness, or other neurological symptoms.
• The cervical spine consists of seven vertebrae or bones (C1–C7) that support the head and protect the spinal cord while allowing a wide range of motion. While fractures are rare in low-speed collisions, the vertebrae may be subject to microtrauma, bone bruising, or minor misalignments. Misalignment or excessive mechanical stress may irritate nearby nerve roots or place strain on the tissues that stabilize the cervical spine.
• Situated between each vertebra, intervertebral disks serve as both shock absorbers and spacers that facilitate motion. If a disk bulges, herniates, or tears, it can compress adjacent nerve roots or the spinal cord, leading to pain or neurological symptoms. Disk injuries, particularly at C5–C6 or C6–C7, are more likely if pre-existing degeneration is present.
• Facet joints are small, paired joints located at the back of each vertebra. Each vertebra has a superior and inferior facet on either side that articulates with the vertebrae above and below. These joints contribute to spinal stability, mobility, and load distribution. During whiplash, overstretching of the joint capsules, ligaments, or surrounding tissues can injure the facets—especially at C2–C3 and C5–C6—resulting in local or referred pain, often into the shoulders or upper back.
• Ligaments are tough, fibrous bands that connect vertebrae and provide structural stability to the spine. When subjected to excessive stretch during whiplash, ligaments can be sprained or partially torn, contributing to pain and perceived instability. The alar and transverse ligaments at the upper cervical spine (C1–C2) are particularly vulnerable and may lead to symptoms like dizziness or balance issues if injured.
• The neck contains both superficial muscles, which facilitate voluntary movement, and deep stabilizing muscles, which maintain posture and balance. Tendons anchor these muscles to bones in the neck, skull, chest, and upper back. During a whiplash event, these muscles and tendons can experience strain, microtears, or reflexive spasms as they work to stabilize the head and neck against sudden acceleration-deceleration forces. The deep stabilizing muscles are particularly vulnerable to injury and dysfunction, which can contribute to chronic pain, impaired proprioception, and persistent stiffness if not properly treated.

Fortunately, many of the soft tissue injuries associated with whiplash respond well to a multimodal chiropractic treatment approach. This may include manual therapies (spinal manipulation, mobilization, and soft tissue techniques); rehabilitative exercises (neck-specific strengthening, range-of-motion work, and graded activity); adjunctive modalities (electric stimulation, therapeutic ultrasound, low-level laser therapy, or pulsed electromagnetic field therapy); patient education; and nutritional guidance. With early intervention and personalized care, most