Restoring Spinal Structure & Function After Whiplash Injury
Chiropractors are often viewed as the “gatekeepers” for whiplash care, and for good reason! Whether you’re in a car accident, sports collision, or other traumatic event, whiplash injury can be the cause of chronic pain and dysfunction. This is because of the structural changes that occur in your spine, which can’t be corrected with rest, muscle relaxers and pain medications. While these things may provide temporary relief, they don’t correct the underlying issue—true recovery focuses on restoring proper spinal structure and function so your body can heal the way it was designed to.
What is Whiplash Injury?
Whiplash occurs when the head and neck are thrust into excessive flexion/extension or side-bending, as a result of impact. The classic example is a rear-end collision, in which the normal banana-shaped curve of the neck is forced into an S-shaped curve through abnormal flexion/extension forces (Shanti, 2023). This is sometimes called an “acceleration-deceleration injury,” because the head is initially accelerated backwards upon impact, then must decelerate as it rebounds forward (Schneider, 2025).
This can cause a variety of symptoms including:
Neck pain/stiffness
Headaches
Dizziness, ringing in the ears
Arm & shoulder pain, paresthesia, and/or weakness
Sleep disturbance
Cognitive changes (memory, concentration, word-finding, fatigue)
Structural and Functional Changes
We never want to neglect pain as a function. It’s a form of communication from your body, which can often interfere with personal and work-related activities. In the event of a whiplash injury, neck pain has been estimated to affect 65% of patients within 6 hours, 93% within 24 hours, and 100% within 72 hours. Pain can often continue for several years, sometimes keeping patients from returning to work (Shanti, 2023).
The most common structural change after whiplash injury is a loss of the normal cervical curve (Schneider, 2025). The natural banana-shaped curve of your neck is designed to optimally absorb the forces of gravity, supporting the weight of your head (and that big brain!). A flattened or reversed curve compromises that function, putting undue stress on the vertebral discs, and recruiting the trapezius muscles for stability.
The subluxation model has been supported by biomechanical studies that link whiplash injury to vertebral translation (misalignment) and pressure on nerves, causing pain and dysfunction (Schneider, 2025).
Additional consequences of whiplash injury include:
Loss of cervical range of motion
Vertebral disc and facet injury
Sprain/strain
Severe injuries such as fracture, spondylolisthesis, etc.
Medical Management
In the absence of severe pathology such as fracture, standard medical management for whiplash injury is pain medication (Shanti, 2023). The following drugs are most common:
Acetaminophen/Tylenol
NSAIDs
Muscle relaxers
Steroids
The problem with this approach is that it ultimately offers nothing more than temporary relief. The underlying cause of pain and dysfunction is not addressed. Furthermore, modern science challenges the use of these drugs outside of select circumstances. While they may be beneficial in some cases, they should not be common practice. For example…
NSAIDs: It has long been understood that controlled inflammation is not a bad thing. In fact, this is your body’s natural healing mechanism! Science has shown that anti-inflammatory treatments (ie. NSAIDs and ice) often inhibit your body’s innate ability to heal itself, slowing the recovery process (Shanti, 2023).
Muscle relaxers: Though effective for pain relief, their clinical efficacy and safety are still uncertain. This is due to their non-specific nature, which can inhibit the central nervous system, and cause dangerous relaxation of important muscles like those used for swallowing and breathing (Shanti, 2023). In our office, patients have shared some concerning experiences with this.
Chiropractic Management
The goal of chiropractic care is to address the root cause of pain and dysfunction after whiplash injury. This often comes down to addressing the structural and functional changes mentioned above. The most consistent and significant results of chiropractic care for whiplash injury are decreased pain, increased cervical range of motion, and restoration of the normal cervical curve/lordosis (Shanti, 2023). Furthermore, Gonstead chiropractors offer specialized care for optimal recovery from disc injuries. A case study from Underhill et. al. describes an example of chiropractic management, and demonstrates the significance of both chiropractic technique and patient compliance with care plan recommendations…
A 13 year old boy presented to the chiropractor for chronic headaches and neck pain following a car accident that occurred one year prior. He inititally sought care from another chiropractor 2 weeks after the accident, but after 8 months of care, his symptoms were not improving. The second chiropractor re-evaluated him, and began 16 weeks of care using a different chiropractic technique. The results were as follows:
Neck pain and functional disability ratings decreased from 7/10 and 37.5% to 0/10 and 0% respectively
Loss of cervical lordosis was restored
Wellness/maintenance chiropractic care and at-home exercises were recommended for the next year, but the patient was not compliant, and symptoms gradually returned at a reduced frequency and intensity. Follow-up x-rays also showed a partial loss of the previously restored cervical lordosis.
The Importance of Maintenance Care
This leads us to our final point of discussion — why is wellness/maintenance care important, especially for whiplash patients?
First, let’s answer this question from a preventive standpoint…
Think of it this way: If you are in a car accident, do you think that a fixated, misaligned, and/or degenerated spine will handle that whiplash injury differently than a freely moving, biomechanically sound spine would?
A review of the scientific literature tells us that the answer is yes! In their research, Malik et. al. identified a statistically significant correlation between total cervical degeneration and non-recovery from whiplash injury.
In our office, we have also observed this to be true for our patients. One patient was in a car accident after a few months under care. He noted feeling significantly better than after a similar, previous accident, and he credited this to how well he was doing when the recent accident occured.
Now let’s answer this question from a long-term recovery standpoint…
Our 13 year old example was completely symptom-free after the initial “active” phase of recommended care, but when he didn’t follow through with additional maintenance recommendations, old issues began to return. This is one of the reasons that wellness care is so important. It breaks the cycle of recurrent pain and dysfunction, so that you’re body can fully adapt and move forward — feeling and functioning well on a consistent basis, for a long time.
The scientific literature confirms this with clinical studies demonstrating significantly greater improvement in patients who completed long-term care recommendations. Achievement of maximal medical improvement (MMI) was associated with 82.1% improvement, while non-compliance was associated with 37.3% improvement.
Conclusion
Whiplash injuries are so much more than just neck pain. There are structural and functional changes that can affect how you feel and function for years to come. This is why it’s so important to address the root cause of the problem, and understand that it takes time and commitment to get results that last. Gentle and specific chiropractic care is a clinically supported, evidence-based option for whiplash recovery, and we love to serve our patients in this way!
References
Malik, K., et al. (2021). Pre-existing Cervical Degeneration a Risk Factor for Poor Prognosis in Whiplash-Associated Disorder. International Journal of Spine Surgery.
Schneider, G. and Librone, P. (2025). Chiropractic Management of Whiplash-Associated Disorders: Improved Outcomes with Completion of Care and Attainment of Maximum Medical Improvement. Vertebral Subluxation Research.
Shanti, B., et al. (2023). Whiplash Injuries: A Systematic Review. Acta Scientific Neurology.
Underhill, M., et al. (2018). Improved Cervical Lordosis Following Chiropractic in an Adolescent with Chronic Cervicogenic Symptoms from a Motor Vehicle Collision: A Case Report & Review of the Literature. Journal of Pediatric, Maternal & Family Health.