Headache Whiplash Injuries

Most of us have heard of whiplash, and headache whiplash injuries.  Whiplash is often caused by an auto accident - when your head is suddenly jerked forward and back again.  Sometimes whiplash is called neck strain or neck sprain.  Other related terms are acceleration flexion-extension neck injury, soft tissue cervical hyperextension injury, cervical sprain or strain, or hyperextension injury.  Another specific term is cervicogenic headache (CEH) (which can be present with or without whiplash).  Whiplash is often used in a more general way; your doctor may use more specific terms.

There are a number of symptoms related to whiplash - neck pain, of course, dizziness, blurred vision, fatigue and memory problems are common.  But our focus today will be on headache whiplash injuries.

What causes headache whiplash injuries?

When the head is jerked back and forth, there is sudden strain on the neck's muscles and ligaments.  This might happen during a car accident, repetitive stress to your neck (like holding a phone between your head and shoulder), a sports injury, a punch or something falling on your head.  The shaking of a child is a common cause in children (child abuse).

Though we know that injury to the neck is involved, there is a great deal of controversy over what exactly causes whiplash headaches of various kinds.  Each patient is different, and has different symptoms, and doctors have different ways of diagnosing.  This means that, although there is a great deal of agreement that there is an injury present, methods of diagnosing and treatment will vary.

Usually, diagnosis will involve moving your neck to see what causes pain, and possibly x-rays, CT or MRI scans.

Continuing whiplash headache pain?

In most cases, the headache whiplash injury will be resolved in the weeks after the original trauma.  However, in a very large minority pain will continue for months.  Generally, the more pain you have initially, the better your chances for a very long recovery time (not an encouraging thought!).  This was found in a study that was shared in January 2008 at the World Congress on Neck Pain.  Read more in the article Whiplash: What Predicts Recovery?

Treatment

We're mostly familiar with the neck collar, though this treatment may not be as helpful as was once thought (see above article).  Many doctors no longer prescribe it, but are looking at other options.  To immobilize the neck for a long period with a collar can lead to other problems.

Because your headache can come from your neck, what helps the neck will also help headache whiplash injuries.

Some common treatments include:

• Massage of the areas where you're feeling pain, especially the neck.
• Ice and heat:  Using ice is common early on in the injury (to decrease inflammation), and heat is used more often later on.
• Stretching and physical therapy:  Your doctor will probably prescribe stretching exercises, and may even recommend physical therapy, especially if the pain goes on for months.
• Medication:  Sometimes the pain is short term and mild, and you don't need much more than a few over the counter painkillers.  More severe pain may call for more powerful medication.  Sometimes a doctor will prescribe injections to numb the pain and avoid muscle spasms, so that you are able to do the stretching exercises that are so important to recovery.
• Rest:  Resting the injured areas can be important, perhaps bed rest early on.
• Alternative treatments:  Some people have found alternative treatments helpful.  You can read about some of these elsewhere on this site, as many treatments for headache whiplash injury are the same as those for any headache.  For example, chiropractic treatment, and Transcutaneous electrical nerve stimulation (TENS) with exercise.

Summary

Headache whiplash injuries can be serious and long lasting, but there are ways to minimize your risk.  Most importantly, protect your head from trauma (using proper sports equipment, seat belts, etc).  Be cautious of repeated injuries.  See a doctor right away, and be sure to get proper follow up.  There is light at the end of the tunnel - even injuries that have lasted months can and probably will resolve in time.

Read more about headache whiplash injuries at the Mayo Clinic.