chronic whiplash why do i still have pain

Chronic Whiplash…Why do I still have pain after all these months?

by Athletico17 Comments

Whiplash is a term used to describe an injury to the neck area that usually involves a rapid movement into extension and flexion, such as in a car accident. Whiplash is the most common non-fatal injury associated with a motor vehicle accident and can even occur at speeds of less than 15 miles per hour. Symptoms of neck stiffness and pain usually appear in the days following the accident and can last for several months, often becoming chronic in 25% of individuals.

I recently took a very interesting continuing education course about why whiplash can cause such chronic painful conditions and how it can be treated. The researchers did studies on individuals who had chronic neck pain from both whiplash disorder and chronic neck pain from other conditions such as degeneration. They found that both groups of individuals had a very different presentation.

In the group of patients that were involved in a car accident, neck muscle degeneration was found. The muscle fibers were replaced by fat content, which started to occur in as little as a few weeks after the accident. This muscle degeneration was not found in the group of chronic neck pain patients due to causes other than whiplash. This suggests that the muscle degeneration is unique to those who had whiplash disorder.

How can we use this information to treat this chronic pain? This study looked at if this muscle degeneration can be reversed. In fact, after a 10 week neck muscle strengthening program, supervised by a physical therapist, the fat deposits in the muscle can be reduced and the size of the muscle fibers were increased. This change in the muscle fibers was also correlated to a reduction in the painful symptoms.

Physical therapy is a main treatment option for individuals who have whiplash disorder. A physical therapist will perform a thorough assessment of your cervical spine movement to see where your limitations are. Based on their findings, a specific exercise program will be implemented along with other treatments such as massage, manual stretches and range of motion exercises. To truly reap the benefits of physical therapy, the patient must be dedicated to attending therapy and performing a home exercise program. With the patient and therapist working together, the symptoms of chronic whiplash can be lessened or hopefully eliminated all together.

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  1. Dr Pullen

    I understand that the newer cars, made of unibody construction, are much more rigid, yet collapse in ways to reduce lethal injury, but actually make the transmission of forces that lead to whiplash worse. Have you found more whiplash in the last decade of newer cars? Are the injuries more serious now?

  2. Liz Hoobchaak

    Thank you Dr. Pullen for your question, it is a very interesting one. As I have only been treating for 7 years, I do not have the experience to compare how whiplash injuries have changed over the past decades. I did try to find some research to support this claim and could not find anything significant. I would be interested in looking into this further and was wondering where you found this information?

  3. Rachel Katz, PT, SEP

    Hi Liz, I am interested in reading the study that showed muscle to fat changes. Can you direct me to a title and link for that?

  4. Jss

    I was hit by a driver going 75 mph who was attempting to change lanes and did not see I was already there. My car went out of control and swerved for over 200 feet, then fell down a 25 foot embankment and flipped over. I have been in physical therapy twice and the pain still keeps coming back. I have had a cat scan of my neck and X-rays of my neck, back, arm and wrist. No fractures. The pain comes and goes with no particular thing setting it off. Sometimes the pain in my neck, back and arm is so bad I can’t lift my arm or make a fist. It’s becoming so exhausting to be in pain sometimes for weeks on end. Some nights my neck hurts so bad I can’t sleep. When the pain flares up it feels like there’s a hard rock or lump in my neck extending down to my shoulder I’m so swollen. I just want to know what this could be and what treatments besides physical therapy might help. I feel so fatigued all the time. The pain has even started to go down and around my shoulder blade. I’m 32 and don’t want to live the rest of my life in chronic pain. My doctor said she wants to send me for an MRI. I’m at a loss because nobody thinks it’s more than whiplash. But it’s over a year, should I still be feeling this bad?!

  5. Dale

    I Have had two whiplash Injuries one In 2000 by a Car. another one 2007 by a Double decker bus.. (lucky Me) .I have found any heavy Lifting still hurts my lower back. Recently i lifted heavy items at work and ended up having Chronic lower back Pain..Is this normal and is it due to the accidents..?

  6. Trisha MacIntyre

    I pulled something in my neck at work by bending over, reaching down and turning my head all the way to the left, upon rising I snapped something. I still 5 months later have swollen area on top of shoulder area and neckpain. 16 visits to PT did nothing, MRI showed no pinched nerve. Now I have to get an ultra sound. I know it’s a muscular injury but, how long before it heals?

  7. ally

    My car wreck in 1982 at the age of 16 left me with sever whiplash, I couldn’t move my head for a couple of weeks. And wore a brace for a time I can’t remember how long. In ’85 I got to be in a head on collision that took my spleen and left me in the hospital for over a month with a week spent in ICU. Fast forward to now April 23, 2016 I am in so much pain all the time I can’t stand it. I have torn my stomach up with NSAID’s to the point they now cause bleeding if I take a small amount. So I am just living with the pain. I work until my fingers go completely numb then I have to wait until the next day to do anymore. My whole body hurts and throbs in pain I go to bed at 9:00 pm to get away from it and dread getting up and starting my day again. I just wish I could get some relief from somewhere if anyone knows of anything I could try.

  8. Lynn

    I was hit while sitting behind two cars at a stop sign 12/2014 and hit again 5/2016 while sitting at a red light. Both drivers said they thought the traffic was moving. The first accident I had to learn to turn my neck again while driving and during the second accident it resurfaced. I was pretty much on the road to recovery with the 12/2014 accident. After the 5/2016 I am still in pain mostly a constant 3 but there are days its a 10+. The doctors can’t understand why I’m not whole again. I wish I was whole again. I wouldn’t trade my health for anything in this world. I’ve gone back and forth to physical therapy and not sure why they medical professional think I will be back to life prior to the first accident. I don’t think it going to happen, because the accidents were so close and I’m not a youngster anymore.

  9. Virginia Frank

    For those of you who have had whiplash especially people who have had two consecutive whiplash accidents, what has been the one thing that has help your discomfort the most?

  10. shell

    I’ve had 2 high speed accidents.
    1. Oblique Impact + spin. double impact.
    2. T-Bone

    Whiplash is a brutal injury, that is so misunderstood.
    Things, that have worked for me.

    Hard muscle tissue’s – this is a very controversial topic. The truth is the medical community does not understand how “connective tissue” responds to trauma!

    This is why we are all suffering.

    After almost 30 years of experience, i believe the body’s reaction to this deep core trauma is to produce more collagen throughout the site of Injury. it creates an internal injury splint. which is a form of protection.
    undetectable by any type of scan. (e.g. won’t show on MRI). This college thickens, slowly hardens, twists and turns-in-on itself. For example, my hand went numb, 5 years after my accident. By then the increase in college/fiber production had strangled the brachial nerves.

    1. Self-massage using a Tennis Ball. (on the floor – or in a chair)

    2. Learn the basic movements of the neck.
    Flexion/extension – Abduction/adduction – Rotation

    3. The McKenzie Method – if you have herniated disks – you can ease the disk back in place yourself. (extension is the key to solving the problems you are experiencing

  11. Linda

    I was hit while sittng stopped at an exit of a large parking lot
    He was probably going 3-5 miles per hour
    It’s been 2 weeks and it still hurts to move up and down and side to side like normal
    Dr says it’s whiplash
    I drive for a living and am concerned looking over my shoulder driving and back and forth for changing lanes all day
    Is it normal to have pain for 2 weeks or a month or more ? Even looking down still hurts
    I’m worried to injure it further

  12. Coreen

    I had a slip and fall almost 5 months ago and have been having ongoing neck, shoulder and back pain, I have burning in my neck shoulder and arms with swelling, red rash, numbness and tingling in my arms and hands off and on and my neck gets stiff and hard to turn my head and neck, trouble swallowing, I can’t stand to bend my head to my chest, should I be worried?

  13. Athletico

    Coreen – Thanks for reaching out. Please contact your physician or call our Injury Hotline at 1-877-ATHLETICO (877-284-5384) to discuss questions with one of our experts.

  14. Viktor Norlander

    Is it possible to find the exercises recommended by the 10 week neck muscle strengthening program somewhere?

  15. bruce fisher

    i was hit at 40mph., diagnosis whiplash., hypertensive emergency., 68 y/old bad mri’s.,

    before accident getting along good., exercise at gym 5-7 days a week., after sccident

    chronic pain., serve headaches., took pt and chro ., person was at fault in florida
    now 6 month later., no relief in site

    thank you

  16. Michelle Hopkins

    Hi. I was rear ended 4 months ago. The car pushed my truck about 100 feet. I seen her in my rear view but that’s all I remember. When it was over I felt pain right away in neck and back. I’ve been seeing a chiropractor but I feel my pain is getting worse. I did get X-rays and have a flat neck now not sure what that is and am getting mris this week because it’s not going away. I feel like I’m gonna feel this way forever

  17. Rose

    I’m not sure where to turn. I had whiplash in an accident two years ago. The pain started in my shoulder and up the right side of the back of my neck up my head to my temple. It doesn’t go that high anymore, stops at the neck from the shoulder. Did physical therapy for months. I would have kept going but missing work to go do the exercisis I am already doing at home , for nearly an hour and 3 or 4 minutes of the therapist’s fingers in the back of my neck relieving all those muscles just seemed silly and buidling up my stress over leaving work early and going in to do what I do at home for 3 or 4 minutes of relief.

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