A whiplash neck injury occurs when the head is abruptly thrown backward and then forward. This violent motion, which happens faster than the body can brace against, can damage soft tissues—including ligaments, muscles, nerves, and disks—as well as cause bone injury or fracture with or without dislocation. Symptoms typically develop within days and may include neck pain and stiffness, reduced motion, headaches (often starting at the base of the skull), shoulder or upper back tenderness, dizziness, fatigue, tingling or numbness in the arms, and pain that worsens with movement. Each case is unique, making recovery time highly variable and difficult to predict.

By following clinical guidelines, healthcare providers can give patients the best chance for recovery. In the absence of red flags (such as fracture, dislocation, neurological compromise, or vascular injury), chiropractic care often focuses on reducing muscle spasm, pain, and inflammation; restoring mobility; encouraging activity within tolerance; and reassuring patients about recovery.

While specifics can vary depending on exam findings, patient preferences, and clinical training and experience, a multimodal treatment approach may include manual therapies including spinal manipulation, mobilization, and soft tissue therapies; manual and/or mechanical cervical traction; pain reducing modalities such as electrical stim, laser therapy, pulsed electrical magnetic field, pulsed ultrasound; dry needling or acupuncture; home exercises to increase muscle strength and improve range of motion; patient education; and diet modifications or supplement recommendations.

Although most injured patients improve within several weeks, up to 50% may continue to experience pain and/or other related whiplash associated signs and symptoms at one year post injury. Investigators have initiated a number of studies to identify which patients may be at greatest risk for prolonged recovery, and though no clear rubric has been established, research suggests the following may be risk factors for chronic whiplash symptoms: older age; a history of back or neck problems (including previous whiplash); pre-existing psychological distress; higher initial pain intensity; pre-existing cervical spine osteoarthritis; and current smoking.

If progress is limited or risk factors for chronic recovery are present, a doctor of chiropractic may coordinate with the patient’s medical physician or a specialist to