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Post-accident neck pain

What is the cause of the problem?

In a rear-end collision, your head is thrown back into over-extension and then bends sharply forwards on the rebound. This is commonly called a whiplash injury, but it is an over-extension injury.

If your car collides with a stationary object, your head bends sharply forwards at first and then rebounds backwards. This results in a similar injury to the neck.

What happens?

• The ligaments binding the vertebrae together are stretched and torn, rather like a sprained ankle. Some bleeding occurs in the ligaments.
• The many small joints in the neck are jarred and bruised.
• X-rays do not usually show up this injury to ligaments and joints.

What are the symptoms?

At first the neck may feel okay, but later (maybe 2 or 3 days later) becomes painful and stiff (like a sprained ankle). Pain in the arms and headache may follow. Some people have difficulty swallowing. Apart from a sore neck, there is a tendency to feel depressed for about 2 weeks. Talk to your doctor about this feeling if it persists.

What is the outlook?

The outlook is invariably very good with a normal recovery, but it may take some months. It will not be speeded up by traction, repeated X-rays or wearing a cervical collar.

What is the treatment?

Like a sprained ankle, the neck needs time to heal, taking at least 3 weeks.

Self-help

Apply icepacks for the first 3 days, then warmth and gentle massage.

Exercise: The best treatment is exercising your neck as soon as possible, even though it feels stiff and tender. Mobilisation therapy can certainly help, but manipulation is not recommended in the first 8 weeks. Your therapist will advise on the best exercises, but any slow, deliberate stretching of the neck is good.

Pain-killers: Paracetamol taken every 4 hours for pain is advisable.

Cervical collar: Support for the neck from a 'collar' with the back higher than the front can help for the first 10 days. Keep the neck in a slightly bent forward non-painful position in the collar. Discard the collar as soon as possible and start moving your neck.

Medication

Your doctor may prescribe a short course of muscle relaxants or anti-inflammatory tablets to make your neck more comfortable.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia