Drugs and Medications for Whiplash
Depending on the severity of your whiplash symptoms, your doctor may prescribe medications and/or spinal injections to deal with the pain. To stress this point: the medications will help relieve your pain, but they won't help heal the injury. Instead, medications and/or spinal injections reduce your pain so that you can work on healing the soft tissue injuries (through physical therapy, for example).
Again, depending on the severity of your pain, you may start with over-the-counter medications. If those don't work to relieve your pain, the doctor may prescribe stronger medications. If prescription medications don't work, the doctor may suggest injections. The progression of treatment depends on your individual symptoms and pain level.
Over-the-Counter Medications for Whiplash
- Acetaminophen: Tylenol is an example of an acetaminophen, a type of medication that has proven to be a good pain reliever. Your doctor may call this an analgesic, but most of us refer to acetaminophen medications as painkillers. They don't help reduce inflammation, though. Acetaminophen works by essentially blocking your brain's perception of pain, and it's good for those pain flare-ups that may come with DDD.
- Over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs): These will help reduce swelling (or inflammation) while relieving your pain. In whiplash, you can have inflammation from the soft tissue injury. If an over-the-counter NSAID is an option for you, you have plenty to choose from. You can use ibuprofen (Advil), aspirin, or Aleve.
By taking an NSAID, you are building up an anti-inflammatory effect in your system, so it's necessary to take it for awhile. That is, NSAIDs won't be as effective if you take them just when you have pain. Because they build up in your body and work to limit inflammation, you may have to take NSAIDs for several weeks before you notice a significant effect on your pain.
Prescription Medications for Whiplash
If over-the-counter medications don't deal with your pain sufficiently, the doctor may prescribe something stronger. The exact type of medication depends on your symptoms, but the doctor may have you try:
- Muscle Relaxants: If you have muscle spasms caused by the whiplash trauma, you may need a muscle relaxant, which should help stop the spasms. Muscle relaxants may also help you sleep.
- Opioids: In the most extreme cases, and only under careful supervision, you doctor may also prescribe an opioid, such as morphine or codeine.
- Prescription NSAIDs: You can take stronger NSAIDs than the over-the-counter variety if your doctor thinks this is best for your pain. For example, he or she may recommend a COX-2 Inhibitor (Celebrex is an example). That's a type of NSAID, but it doesn't cause gastrointestinal side effects as other prescription NSAIDs can.
Injections for Whiplash
Injections for whiplash are most effective when combined with a physical therapy or exercise program that helps you work on strengthening the neck muscles. The injection should give you pain relief so that you can turn your attention to healing the actual injury. Several types of injections used for whiplash are:
- Epidural Steroid Injection: This is one of the most common injections. An epidural steroid injection (ESI) targets the epidural space, which is the space surrounding the membrane that covers the spine and nerve roots. Nerves travel through the epidural space and then branch out to other parts of your body, such as your arms. If a nerve root has become compressed (pinched) in the epidural space because of a whiplash injury, you can have pain that travels down your neck and perhaps into your arms (a symptom called radiculopathy).
An epidural steroid injection sends steroids—which are very strong anti-inflammatories—right to the nerve root that's inflamed. This is a pain management therapy, so it's best to have a well-trained pain management specialist do the injection. You'll probably need 2-3 injections; generally, you shouldn't have more than that because of the potential side effects of the steroids.
- Facet Joint Injection: Also known as facet blocks, facet joint injections are useful if your facet joints are causing pain. Facet joints in your spine help you move and provide stability. If they become inflamed, though, because of how the whiplash injury affected your cervical spine anatomy, you'll have pain. A facet joint injection will numb the joint and can reduce your pain.
View Facet Joint Block Video
- Trigger Point Injection: In more extreme cases of whiplash, trigger point injections are a good option. (Trigger points are knots of muscle under the skin that form when muscles do not relax.) The injection contains a local painkiller that sometimes includes a corticosteroid to reduce the inflammation.