Doctors' Choice Physical Medicine

Whiplash – Where Is My Neck Pain Coming From?


Last week while driving to work, you’re stopped at a red light, glanced in the rearview mirror.  You noticed that the car behind you is going way too fast.  The next thing you remember is the squeal of the tires and a loud crash with an accompanied sudden jolt as your car was propelled forward by the impact.  You were just in a car crash. Your initial reaction is one of shock, wondering if you are hurt.  Was anyone hurt?  How bad is my car damaged?  Will there be another hit?  Should I get out of the car?  I’m going to be late for work!

Within a few minutes, the police arrive and take statements from you, the other driver, and a few witnesses.  You decline an ambulance offer to take you to a nearby hospital for an examination.  You’re thinking, “…this little stiffness and ache in my neck is no big deal.”  You’re happy you can still drive your car; you arrive at work an hour and a half late. 

Once you get to work, you review the details of the crash with co-workers.  You begin to notice a headache, your neck stiffens up and movements becoming limited and painful.  After another couple of hours, you pop a few Ibuprofens but the pain has increased and you now have a whopping headache.  You decide, “I better go see my chiropractic physician to see if something is wrong.”  You need neck pain relief!


After the exam and x-rays, the chiropractic physician explains the mechanism of injury that usually occurs in a low speed rear-end collision.  The doctor said a few things that really hit home.  You start to understand how such a seemingly minor crash can create so much neck pain. The first is that the injury occurred faster than your brain or memory could process the car accident.  Upon impact, as your car was propelled forwards, your head initially stays still.  Depending upon the height of the headrest your head may have then extended backwards stretching the muscles in the front of your neck to or exceeding their limits.  Your head is then “whipped” forwards in a “crack the whip” type of response and all of this takes less than 600-700 milliseconds!  In other words, the crash was over before your brain knew it!  The ligaments that hold the vertebra together are often stretched and/or torn.  Discs may be herniated.  This can be appreciated on the bending neck x-rays, which shows one vertebra sliding forwards on the one below.

The second point was the fact that your head may have been rotated at the time of impact from looking in the rearview mirror.  This places your neck at a greater risk of injury because of the twisting motion that occurs during the “crack the whip” process. During a low speed collision there is not a lot of car damage.  The force of the impact was not absorbed by crushing metal like the one you see in NASCAR crashes.  In low speed collisions, almost all of the energy is transferred through the car to the occupants.  That is why your briefcase ended up on the floor and your glasses flew off during the crash.


Did you know there is a difference between male and females and the degree of injury?  Women are more likely to have a more serere personal injury because their neck muscles are weaker and usually have longer necks. Preexisting conditions, such as osteoarthritis in the neck may also result in more severe injury. So, if you are a middle aged, female with a long slender neck with pre-existing arthritis looking in the rearview mirror prior to impact in a rear-end collision, resulting in ligament over stretching/tearing it is highly probable that you are more severely injured than your male counterpart sitting next to you during the collision. Generally, most chronic neck pain comes from the spinal discs and joint capsules behind the discs.

In summary, it is important to obtain prompt evaluation and treatment by your chiropractic physician as soon as possible.  Taking medication for pain only postpones the needed process of restoring movement and function of the neck.  Meds can help the inflammation but they do nothing to restore the mechanical problems of the injury. In general, a “wait and watch” approach is not wise in these types of injuries.

If you or a loved one is suffering with whiplash, sharing this information may be one of most significant acts of kindness that you can give to those that you care about. Get the treatment you need, there is plenty of time to see an accident lawyer, if you need one, for your personal injury. Looking for more information?

Doctors’ Choice Physical Medicine and Rehab

Dr. David Novatnak

Glee Pascual, Physical Therapist

Pottsville Schyulkill County PA