The pain usually isn’t worst at the scene. It arrives the next morning, or the one after, and by then the car is sorted and the neck isn’t.
Most whiplash settles. What decides how the next few weeks go is mostly what you do in them, and the instinct almost everyone has is the wrong one.
Get checked first
Before any of this, a neck injured in a collision should be assessed rather than self-managed. Go to a doctor or A&E, the same day, if any of these apply:
- Pain, numbness, tingling or weakness in an arm or hand
- Tenderness down the middle of the neck over the bones, rather than the muscles either side
- You can’t turn your head to look over each shoulder
- Severe headache, dizziness, visual changes, slurred speech or unsteadiness
- You lost consciousness, or you’re confused, drowsy or vomiting
- You’re over 65, have osteoporosis, or it was a high-speed impact
A heat pad is for ordinary muscular neck pain once someone has ruled the serious things out.
The first two or three days
This is an acute injury, so cold suits the first 48 to 72 hours better than heat: 10 to 15 minutes at a time, wrapped in a thin towel. See the 48–72 hour rule and heat or ice: a physio’s decision guide.
Some people find warmth more comfortable even in those first days, because a lot of the pain is muscle guarding rather than swelling. If cold makes you tense up harder, warmth on a low setting is a reasonable swap. Comfort is a fair guide here.
After that, heat and movement
From day three or so, the problem is stiffness and muscles holding on. That’s what heat is for.
- Sit upright and supported, pad across the back of the neck and the tops of the shoulders, cover on, lowest setting, 15 minutes. Placement detail: heating pad for neck pain.
- Then move, gently and within comfort: slow turns each way, ear towards shoulder, chin tucks, shoulder rolls. Ten of each.
- Repeat a few times a day rather than one long session.
The movement is the treatment and the heat is what makes it tolerable: “my physio said use heat” — but how, exactly?
The instinct to protect it is the problem
A painful neck after a crash makes people hold it still, take time off, and wait for it to feel normal before using it. That approach has been studied a great deal in whiplash, and it does worse than staying active.
Soft collars have largely fallen out of favour for ordinary whiplash for the same reason: a neck held still stiffens and weakens. Unless a doctor has specifically given you one, keep moving.
Practical version: return to your normal routine as soon as you reasonably can, keep driving if you can turn your head safely, and don’t cancel the next month waiting for zero pain.
What else turns up with it
- Headaches from the base of the skull. Common, and they often ease as the neck does. See tension headaches from the neck and shoulders.
- Pain between the shoulder blades, from the same braced posture. See shoulder blade pain.
- Poor sleep, which lowers pain tolerance and makes everything read as worse. A pillow that keeps your head level with your spine helps: a stiff neck after waking up and warmth before bed.
- Tension and anxiety about the accident. Muscles hold on when you’re on edge, and that’s a real contributor rather than a soft one: stress and tight shoulders.
How long
Most people improve substantially over a few weeks. A proportion take months, and pain lasting longer doesn’t mean something was missed or that you’re imagining it.
If you’re still stiff and sore after two or three weeks, see a physiotherapist rather than continuing to manage it with heat alone. Graded exercise for the neck and shoulder blade muscles is what shifts the persistent cases, and a pad on its own won’t get you there.
Go back to a doctor if…
- Arm symptoms appear or worsen: pain, numbness, tingling, weakness
- Headaches are getting worse rather than better
- You develop dizziness, visual changes or unsteadiness
- Pain is severe at rest or waking you every night
- You have clumsiness in the hands or a change in walking or bladder control. Go the same day.
Longer term, if the neck stays stiff and grindy months later, see neck arthritis and stiffness.
The heat pad we use
We’ve supplied the Bremed BD7800 since 2010. It holds a steady temperature, covers a whole lower back and has a machine-washable cotton cover. Physiotherapy clinics in Singapore use it with their patients.
Clinically reviewed by: Nigel Chua (Hand Occupational Therapist) & Louise Yow (Physiotherapist). This article is general information, not a diagnosis. electricheatpad.com sells electric heat pads.
