Whiplash refers to an acceleration–deceleration injury of the neck, typically resulting from rear-end vehicle collisions, sports trauma, or sudden impact.
The term Whiplash-Associated Disorder (WAD) describes the range of symptoms that may follow such trauma — including neck pain, stiffness, headaches, dizziness, and cognitive or emotional changes.
Whiplash injuries are among the most common causes of neck pain in Western countries, with an estimated incidence of 3–4 per 1,000 people per year.
While most individuals recover within a few weeks, up to 30–50% may experience persistent symptoms lasting months or years.
Modern research shows that whiplash involves not only local tissue strain but also changes in pain processing, muscle control, and autonomic regulation, which together contribute to chronicity.
Neck pain and stiffness, often worsening over 24–48 hours after injury.
Headache (typically occipital or cervicogenic).
Shoulder or upper back pain.
Dizziness, visual disturbance, or balance changes.
Fatigue, poor concentration, or sleep problems.
Heightened sensitivity to touch, sound, or light in chronic cases.
Functional impact:
Whiplash can interfere with work, driving, exercise, and social life. Persistent cases may also affect mood, leading to frustration or fear of movement.
Red flags:
Severe pain, neurological weakness, numbness, loss of coordination, or symptoms suggesting spinal cord injury (myelopathy) require immediate medical evaluation.
Whiplash is a multifactorial condition, not limited to muscle or ligament injury. Contributing mechanisms include:
Soft-tissue microtrauma: strain of cervical muscles, ligaments, or joint capsules.
Facet joint irritation: a major pain generator in many whiplash cases.
Altered muscle control: deep stabilising muscles inhibited, superficial muscles overactive.
Autonomic dysregulation: increased sympathetic activity affecting heart rate, sweating, or dizziness.
Central sensitisation: amplification of pain processing in the nervous system.
Psychosocial and emotional factors: stress, anxiety, and catastrophising may prolong symptoms.
Effective recovery therefore requires a biopsychosocial approach — integrating physical, neurological, and behavioural care.
Osteopathic management focuses on restoring motion, reducing protective tension, and supporting self-regulation across the cervical, thoracic, and cranial regions.
An osteopathic assessment may include:
Detailed case history and screening for red flags or contraindications.
Evaluation of cervical and thoracic motion, posture, and breathing mechanics.
Gentle, indirect manual techniques (myofascial release, functional, cranial, or counterstrain) to reduce soft-tissue tension and autonomic arousal.
Gradual reintroduction of safe movement to help restore normal sensory–motor control.
Collaboration with physiotherapists or pain specialists when persistent sensitisation is present.
Osteopathic treatment aims to enhance comfort and mobility, reduce sympathetic dominance, and support the body’s adaptive capacity, rather than simply “correcting alignment.”
Evidence supports multimodal conservative care as the best approach to whiplash-associated disorders.
Early gentle movement, education, and manual therapy can aid recovery and reduce disability.
Osteopathic and manual therapies have been shown to improve pain, range of motion, and quality of life, particularly when combined with active rehabilitation and reassurance.
Sterling M. Whiplash-associated disorders: a review of recent progress. Pain Res Manag. 2011;16(6):401–408. Link
Carroll LJ, Holm LW, Hogg-Johnson S, et al. Course and prognostic factors for neck pain in whiplash-associated disorders (WAD): results of the Bone and Joint Decade 2000–2010 Task Force. Spine. 2008;33(4 Suppl):S83–S92. Link
Kasch H, Bach FW, Jensen TS. Neurogenic mechanisms in neck pain following whiplash injury. Pain. 2001;93(3):305–313. Link
Michaleff ZA, Maher CG, Verhagen AP, Rebbeck T, Lin CW. Accuracy of the Quebec Task Force classification of whiplash-associated disorders: a systematic review. Spine. 2012;37(1):E44–E51. Link
Teasell RW, McClure JA, Walton D, et al. A research synthesis of therapeutic interventions for whiplash-associated disorder (WAD): part 4 – noninvasive interventions for chronic WAD. Pain Res Manag. 2010;15(5):287–294. Link
Humphreys BK, Peterson CK. Osteopathic and chiropractic manual therapy for neck pain and whiplash: a systematic review. J Manipulative Physiol Ther. 2013;36(7):490–502. Link
Cerritelli F, Esteves JE, Martelli M, et al. The effect of osteopathic manipulative treatment on pain and autonomic function in patients with chronic neck pain: a randomized controlled trial. J Pain Res. 2021;14:1519–1530. Link
Xie Y, Chen Z, Yang Z, et al. Comparative efficacy and safety of manual therapy interventions for whiplash-associated disorders: a network meta-analysis. Front Neurol. 2024;15:1507245. Link
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