---
title: "Whiplash"
---
## When the Pain Doesn't Go Away
You remember exactly when your whiplash happened. The car accident. The fall. The sports collision. You probably went through the standard sequence: imaging that came back mostly normal, a soft collar for a few days, instructions to take ibuprofen and rest, a referral to physical therapy.
For many whiplash patients, this is enough, and symptoms resolve over weeks to a few months. For others, the pain does not go away. Weeks turn into months, months into years. You have been told your imaging looks fine and the pain should have resolved by now. If this describes your experience, you are not alone. Persistent post-whiplash pain is a recognized clinical condition with specific underlying causes and specific effective treatments. The challenge is that those treatments often are not part of standard post-injury care.
## Why Whiplash Sometimes Doesn't Heal Cleanly
The mechanism of whiplash produces specific patterns of damage that do not always show clearly on standard imaging. The most common identifiable source of persistent post-whiplash pain is injury to the cervical facet joints, the small joints at the back of each cervical vertebra.
The rapid acceleration-deceleration force exceeds the normal range of motion for cervical structures. The facet joints can sustain microscopic damage, ligamentous strain, or capsular injury that is real but does not appear on standard MRI. The body's healing response stabilizes things partially but often leaves the joints inflamed, irritable, or dysfunctional. The result is chronic pain that may be located in the neck (sometimes one-sided), referred to the back of the head, upper shoulders, or between the shoulder blades, worse with certain head positions, associated with stiffness, not visible on imaging, and often accompanied by tension-type or cervicogenic headaches. This pattern is well-documented, and targeted treatment of these joints often produces meaningful relief.
## Common Whiplash Symptoms We See
Patients with persistent post-whiplash pain often experience some combination of chronic neck pain at the site of original injury, limited neck range of motion, recurrent or daily headaches that started or worsened after the injury, pain referred to the upper back or shoulders, stiffness that is worst in the morning or after sustained postures, sleep disruption, tension in the upper trapezius and surrounding muscles, and sometimes cognitive symptoms or mood changes related to the persistent pain. The combination varies by patient, but the underlying pattern of cervical facet involvement is common.
## How PHI Treats Persistent Whiplash Pain
The first step is comprehensive evaluation: a detailed history of your original injury and symptoms over time, an examination of cervical range of motion and tender points, review of imaging, and sometimes a diagnostic injection to confirm the specific cervical structures involved.
Cervical facet injections are typically the first interventional treatment, delivering anti-inflammatory medication into or near the cervical facet joints, with the response itself often confirming facet involvement (see our Cervical Facet Syndrome page). Cervical radiofrequency ablation is the natural next step for patients whose injections confirm the source but produce shorter-than-desired relief, providing relief that typically lasts 6 to 18 months. PRP therapy may be appropriate for selected patients with significant soft tissue components, delivering concentrated growth factors to support healing in injured ligaments and tendons. PHI performs every cervical procedure in our affiliated surgical suite under image guidance, and coordinates with physical therapy and other specialists for patients whose symptoms involve significant biomechanical or functional components.
## Why PHI for Whiplash Treatment
## Frequently Asked Questions
**Q: My MRI looked normal but I still have pain. Why?**
This is one of the most common scenarios with whiplash. Cervical facet injury, the most common source of persistent post-whiplash pain, does not always appear on standard MRI. The pain is real, the source is identifiable through physical examination and diagnostic injections, and effective treatment exists.
**Q: How long should whiplash symptoms last?**
Many cases of acute whiplash improve significantly over weeks to a few months with appropriate care. If symptoms persist beyond 3 to 6 months, you have what is called persistent or chronic whiplash-associated disorder, a recognized condition that often benefits from specific interventional evaluation.
**Q: Is it too late to get treatment if my injury was years ago?**
No. Patients with persistent post-whiplash pain often respond well to targeted treatment regardless of how long they have been dealing with symptoms. The cervical facet structures involved do not heal differently based on how long ago the injury occurred.
**Q: Why didn't physical therapy fully resolve my whiplash?**
PT is appropriate first-line care and helps many whiplash patients. For patients with significant cervical facet injury, PT alone often is not sufficient because it does not address the underlying joint involvement directly. Combining interventional treatment of the facet joints with continued PT often produces results neither approach achieves alone.
**Q: How effective is radiofrequency ablation after whiplash?**
For patients whose diagnostic facet injections confirm the source, cervical ablation produces meaningful pain relief lasting 6 to 18 months in most patients. The procedure can be repeated when relief diminishes.
**Q: Will my whiplash get better on its own?**
Some persistent post-whiplash pain does resolve spontaneously over time. Much does not. The longer symptoms persist, the more chronic pain patterns can become established, and earlier targeted treatment often produces better outcomes than continued waiting.
**Q: What if I had a head injury along with my whiplash?**
Concurrent concussion alongside whiplash is common. The neck symptoms and any persistent post-concussive symptoms may need to be addressed separately or through coordinated care. PHI handles the cervical component, and coordinated care with neurology may be appropriate for ongoing post-concussive symptoms.
**Q: Will I need surgery?**
The vast majority of whiplash patients do not need surgery. Persistent post-whiplash pain typically responds well to non-surgical interventional treatment. Surgery is rarely the right answer for whiplash specifically.
**Q: Do you take insurance?**
Insurance coverage and payment options may vary. Please contact our office to discuss your specific plan, available options, and pricing. All pricing is transparently disclosed at consultation.
**Q: Do you accept international patients?**
Yes. PHI regularly treats patients from outside Los Angeles, including Las Vegas, Palm Springs, London, and other international locations.
## Treatments We Offer for Whiplash
PHI offers evidence-based treatments for persistent post-whiplash pain. Your physician will recommend the right option, or combination, based on the specific structures involved in your case.
- Cervical Facet Injections, usually the first interventional step
- Radiofrequency Ablation, 6 to 18 months of relief when injections confirm the source
- PRP Therapy, for significant soft tissue components
> Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining whiplash and its management. Peer-reviewed via PubMed.
— [Spitzer WO, et al.](https://pubmed.ncbi.nlm.nih.gov/7604354/)
> Consensus practice guidelines on interventions for lumbar facet joint pain from a multispecialty, international working group. Peer-reviewed via PMC, 2020.
— [Cohen SP, et al.](https://pmc.ncbi.nlm.nih.gov/articles/PMC7362874/)
## Schedule Your Whiplash Consultation
A 60-minute consultation will identify the specific structures contributing to your persistent post-whiplash pain, walk through the treatment options that match your situation, and give you a clear plan. Call (310) 856-9488 or book online now.
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