Whiplash Treatment in Castle Rock
What is Whiplash?
Whiplash is a neck injury caused by a rapid back-and-forth movement of the head, most commonly from rear-end car accidents. The sudden acceleration and deceleration forces can damage multiple structures in the cervical spine, including the facet joints, intervertebral discs, muscles, ligaments, and nerves.
Most whiplash injuries improve within a few weeks to months with conservative treatment. However, about 25 to 40% of patients develop chronic neck pain that persists beyond three months. When whiplash pain becomes chronic, it is most commonly coming from the cervical facet joints, which are particularly vulnerable to injury during the whiplash mechanism.
What Does Whiplash Feel Like?
Neck pain and stiffness that may begin hours to days after the injury
Headaches, typically starting at the base of the skull
Pain that worsens with neck movement, especially looking up or turning the head
Reduced range of motion in the neck
Shoulder and upper back pain
Dizziness or a sense of unsteadiness
Fatigue
Arm pain, numbness, or tingling if a disc herniation or nerve injury occurred
When Should I Seek Evaluation?
If you are in a car accident and develop neck pain, it is reasonable to be evaluated promptly, especially if the pain is severe, if you have headaches, or if you notice arm symptoms (pain, numbness, weakness). Do not wait to see if it resolves on its own. Early documentation and treatment can prevent the injury from becoming a chronic problem.
Seek immediate evaluation if you have severe pain after trauma, weakness in the arms or legs, difficulty walking or with balance, or new bowel or bladder problems.
How is Whiplash Diagnosed?
Whiplash is diagnosed based on your history (mechanism of injury), symptoms, and physical examination. X-rays may be taken to rule out fractures. If symptoms persist or worsen, an MRI may be ordered to evaluate the discs, facet joints, ligaments, and nerve roots.
One challenge with whiplash is that the initial imaging may appear normal even though structures have been injured. The cervical facet joints and ligaments can sustain damage that is not visible on standard imaging. This is why persistent whiplash pain often requires diagnostic injections to identify the source.
Why Does Whiplash Sometimes Become Chronic?
The cervical facet joints are the most common source of chronic pain after whiplash. During the whiplash mechanism, the facet joints are compressed and stretched beyond their normal range, which can damage the joint cartilage and surrounding capsule. This damage may not show up on imaging but causes persistent pain that is worse with extension and rotation of the neck.
Other structures that can cause chronic symptoms include damaged discs (which may herniate or degenerate faster after injury), injured ligaments, and in some cases, the development of CRPS or central sensitization.
How is Whiplash Treated?
Acute phase (first few weeks): Activity modification (but not prolonged rest - staying active is important), anti-inflammatory medications (NSAIDs), muscle relaxants for spasm, ice and heat, and gentle range-of-motion exercises. The goal is to keep the neck moving and prevent stiffness.
Physical therapy: Cervical stabilization exercises, postural correction, and gradual strengthening. Physical therapy is the foundation of whiplash treatment and should begin as early as tolerated.
Medications for persistent pain: If pain continues beyond the acute phase, nerve-calming medications (gabapentin, pregabalin) may help, especially for headaches and radiating arm symptoms.
Facet joint injections and medial branch blocks: For chronic whiplash pain (beyond 3 months), facet joint injections or medial branch blocks can determine whether the cervical facet joints are the source. If they confirm facet-mediated pain, radiofrequency ablation (RFA) of the cervical medial branches can provide 6 to 18 months of relief.
Epidural steroid injections: If whiplash caused a cervical disc herniation with arm pain, a transforaminal or interlaminar epidural can target the compressed nerve.
Occipital nerve blocks: For whiplash-related headaches originating from the upper cervical spine or greater occipital nerve.
Schedule an Evaluation
If you are experiencing neck pain, headaches, or arm symptoms after a car accident or other injury, Dr. Carrera's team can evaluate the source of your pain and start treatment. Early intervention helps prevent whiplash from becoming a chronic problem.