Home / Conditions / Whiplash injury
A neck injury from a sudden back-and-forth jolt, most often a rear-end car collision. Most people recover within weeks to a few months — the first job is making sure nothing more serious than a sprain has happened.
In a whiplash injury the head is thrown backwards and then forwards, or the other way round, faster than the neck muscles can react. The soft tissues of the neck — muscles, ligaments, and the small joints between the vertebrae — are stretched beyond their normal range.
When the head is thrown back, the front of the neck is stretched and the small facet joints at the back are pressed together and strained. When it is thrown forward, the ligaments at the back are pulled, and can tear, along with the facet joint capsules.
What the drawing cannot show is why pain can outlast the injury. The facet joints are strained in both movements, and they are one of the commonest sources of neck pain that lingers after whiplash — which is why facet joint blocks feature in treatment when pain does not settle.
The classic cause is being hit from behind in a car, even at low speed. Sports, falls and assaults can do the same. Because the injury is to soft tissue, symptoms often build over the first day as the tissues stiffen and swell.
A head injury can happen in the same accident. Confusion, memory problems, sensitivity to light or noise, or feeling “not right” after a collision suggest a concussion as well as a neck injury, and need assessing in their own right.
Whiplash injuries are graded by what the examination finds. The grade decides whether a scan is needed and what happens next.
| Grade | What is found | What it means |
|---|---|---|
| 1 | Neck pain, stiffness or tenderness only | A mild sprain. Usually settles with staying active |
| 2 | Pain with reduced neck movement and tender spots | A more significant sprain. The commonest grade |
| 3 | Numbness, weakness or reflex changes in the arms | A nerve is involved. Needs a neurological assessment, and often a scan |
| 4 | A fracture or dislocation | A bony injury. Needs emergency care |
A scan is not needed for every whiplash injury. It is advised after higher-risk injuries — age 65 or over, a high-speed or rollover collision, a fall from height, tingling in the arms or legs, or being unable to turn the head — and not routinely for a simple sprain.
Call 995 or go to an emergency department. Keep the head and neck still until help arrives.
For neck pain after an accident without these signs, call us on +65 8849 0677 and we will arrange an assessment.
Call 995A normal scan is the usual result. Whiplash is mostly an injury to muscles and ligaments, which scans rarely show. A normal scan rules out the serious injuries; it does not mean the pain is not real.
The aim is to control pain and get the neck moving normally again. Early movement is one of the most effective things you can do.
Gentle neck movement from the start, and a gradual return to normal activities. Soft collars are best avoided: keeping the neck still tends to slow recovery. Ice in the first day or two, then heat, can ease pain.
Simple painkillers or anti-inflammatories, taken regularly enough to keep moving. A short course of a muscle relaxant sometimes helps with spasm.
For symptoms that are not improving after a few weeks: exercises to restore movement, strength and posture have the strongest evidence.
When pain persists for months, the small joints at the back of the neck are a common source. Image-guided facet joint blocks can confirm this, and radiofrequency nerve ablation can then give longer relief. Dr Tung works with radiologists to offer both.
A squeezed nerve is treated as cervical radiculopathy. A fracture or unstable ligament injury may need a brace or, rarely, surgery.
Most neck pain after whiplash improves within the first few weeks, and many people have recovered by three months. A significant minority still have some neck pain a year later. Severe pain from the start, early arm symptoms, and high distress after the accident are the clearest signs that recovery may take longer — and a reason for earlier assessment rather than waiting.
Whiplash can involve the nerves, the head, the joints and the bones of the neck. Which side leads depends on what the injury has affected.
Arm numbness or weakness, lingering neck pain from the facet joints, or a head injury in the same accident.
A neurosurgeon trains on the nervous system first. Dr Mathew Tung treats head injury and concussion, and offers CT-guided facet blocks and radiofrequency nerve ablation.
A suspected fracture, an unstable neck, or injury elsewhere from the same accident.
An orthopaedic surgeon trains on the musculoskeletal system first. Dr Lim Heng Hing treats spinal conditions and trauma, and Dr Jeffrey Tan sees whiplash injury alongside other neck and back problems.
You do not need to pick correctly. Any of them is a sound first appointment for whiplash, and having them in one clinic means the answer is not shaped by whichever one you happened to book.
More on how the two differ: neuro spine and orthopaedic spine surgery.
Whiplash is a soft-tissue injury. Stiffness and swelling build over the first 24 to 48 hours, so it is common to feel fine at the scene and much worse the next morning.
Usually not. For a whiplash sprain, keeping the neck still tends to slow recovery. Gentle movement within comfort is better. A collar is only used if a fracture or unstable injury is suspected or confirmed.
Not always. Imaging is advised after higher-risk injuries, such as in people aged 65 or over, after a high-speed collision or fall from height, with tingling in the limbs, or when the head cannot be turned. A simple sprain does not need one.
Most people improve within weeks, and many have recovered by three months. Some have neck pain for longer, especially after a severe initial injury or early arm symptoms.
Yes. Headache from the neck and dizziness are both common after whiplash. If they come with confusion, memory problems or sensitivity to light, a concussion should be considered as well.
No. Bring any scan reports or hospital notes from the accident, and note when your symptoms started.
Neck pain · Cervicogenic headache · Concussion · Cervical radiculopathy · Dizziness and vertigo · Cervical spondylosis · Rhomboid pain
If you were seen at a hospital after the accident, bring the notes or scan reports. They save repeating tests.
