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The common symptoms and signs associated with whiplash include:

. Stiff neck
. Neck pain when rocking the head backward and forward or side to side
. Headaches at the back of the head
. Muscle spasms and tenderness
. Loss of neck range of motion
. Tingling, numbness, and/or weakness in the arms
. Tenderness or pain of the arms, upper back, and/or shoulders

Whiplash occurs as a result of trauma or injury. This includes:

. Physical abuse/assault - Any incident that leads to being shaken or punched can cause cervical strain.
. Auto accidents - Rear-end collisions are the most common cause of whiplash.
. Contact sports - Injuries related to collision can often cause cervical strain.

Cervical strain is often associated with a concussion, which can be serious. The doctor will assess your neck and rule out concussion. In addition, test ordered may include:

. X-rays - Used to identify fractures of vertebrae.
. Computed tomography (CT) scans - Used to assess soft tissue structures of the neck.

The goals of cervical strain treatment are to restore normal range of motion to your neck, control or eliminate pain, and to return you to regular activities. Treatment options include:

Rest - This is recommended for the first 24 hours after the initial impact or injury.

Physical therapy - The doctor will recommend that you work with a therapist, who uses pain relief measures of massage, heat/ice therapy, electrical stimulation, and ultrasound. In addition, to restore range of neck motion, the therapist will instruct you on strengthening and flexibility exercises.

Medications - Non-steroidal anti-inflammatory agents are used for relief of pain (ketoprofen and naproxen). In addition, the doctor will often prescribe muscle relaxants (baclofen or flexiril) to alleviate spasms. For severe pain, short-term painkillers may also be prescribed.

Cervical collar - A soft, foam cervical collar is only to be used short-term, after the initial injury. Prolonged periods of use will decrease muscle strength and impair recovery.

Trigger point injections (TPIs) - The doctor injects lidocaine (anesthetic agent) into painful muscle areas to decrease pain of the upper back and neck muscles. In a recent review of several clinical studies, TPIs were found to be superior to no intervention for relief of neck/back pain.

Botox - Botulinum toxin (Botox) can be injected into the neck muscles and shoulders to paralyze them. This agent prevents painful contractions associated with cervical strain. In a recent study of Botox used to treat the pain associated with whiplash, participants reported significant pain relief and functional improvement after injections.

Medial branch block (MBB) - This procedure involves injection of an anesthetic, with or without a steroid agent, into the small cervical facet joints, which are along the vertebrae. A recent study found this procedure to have a success rate of almost 100%, with many patients reporting 50% reduction of pain and improved neck motion at 3,6, and 12 month follow-up visits.