cervical strain

Last edited 10/2022 and last reviewed 10/2022

Whiplash injury is a combined flexion / extension soft-tissue injury of the cervical spine, common in road traffic accidents (1).

There are two types of injury:

  • in a rear end shunt, the head is thrown backwards and the neck is hyperextended. This tears the anterior longitudinal ligament resulting in bleeding between the ligament and the vertebra. There may be retropharyngeal swelling and dysphagia within hours of the injury.

  • a rapid deceleration injury throws the head forwards and flexes the cervical spine. The chin limits forward flexion but the forward movement may be sufficient to cause longitudinal distraction and neurological damage. Hyperextension may occur in subsequent recoil.

Analgesia and patience are the only treatments (2).

  • studies suggest, however, that early mobilization may lead to improved outcomes and that rest and motion restriction may hinder recovery

Many other therapeutic interventions have been suggested including temperomandibular joint treatment, cervical traction, intraarticular corticosteroids, and botulinim toxin - evidence to support their use is lacking (3)


  • Borchegrevnik GE, Kaasa A, McDonagh D, et al. Acute treatment of whiplash neck sprain injuries. Spine 1998;23:25-31.
  • Barry M, Jenner JR. Pain in neck, shoulder and arm. BMJ 1995;310:183-6
  • Curr Rev Musculoskelet Med. 2008 Mar;1(1):65-8.