Key takeaways

Whiplash is a soft-tissue neck injury from rapid back-and-forth motion. Symptoms can take hours or days to appear.
Much of the headache comes from guarding muscles at the base of the skull, but a worsening headache, vomiting, confusion, or unequal pupils are emergency signs.
Pregnancy narrows imaging and medication decisions and makes side-lying sleep harder, so the exam matters more, not less.
Say neck and say pregnant when you call. Tell them what your OB said.

Rear-end hits are the metro's most ordinary crash and the neck is what they are built to strain. The car stops, the body keeps going until the belt catches it, and the head, which the belt does not hold, keeps going a beat longer before snapping back against the headrest. The neck takes that motion in both directions. The next morning it announces what it took.

What whiplash is

Whiplash is the common name for a neck injury caused by a rapid back-and-forth movement of the head, the kind a rear-end collision produces. The National Institute of Neurological Disorders and Stroke lists neck pain and stiffness, headache, dizziness, and pain in the shoulders or upper back among the usual symptoms, and notes that they can appear immediately or take hours or days to show (ninds.nih.gov). The structures involved are the soft ones: muscles, ligaments, and the small joints between the bones of the neck. Bone is usually fine. That is why a clinic can examine it and why the emergency room, for the uncomplicated case, is the wrong destination.

Why the headache

Much of the headache after a rear-end hit comes from the neck itself. The muscles at the base of the skull tighten to guard the strained joints beneath them, and that tension refers pain up over the back of the head and sometimes behind the eyes. It tends to be worse after sleep, worse with turning, and better as the neck loosens. It is a common part of the whiplash picture and it is exactly the kind of thing a documented exam should note, with a date, so that the next week can be measured against it.

A headache can also mean the head was hit, or that the brain was shaken inside the skull even without a blow. That is a different injury with a different set of warning signs, and the warning signs are the next section.

The signs that are an emergency, not a clinic question

The Centers for Disease Control and Prevention publishes a plain list of danger signs after a head injury (cdc.gov): a headache that gets worse and does not go away, repeated vomiting, slurred speech, one pupil larger than the other, unusual drowsiness or inability to wake up, convulsions, weakness or numbness, or worsening confusion. Any of those is an emergency room trip now. So is this desk's standing line:

The emergency lineChest pain, a sudden severe headache, weakness or numbness on one side, trouble speaking, a loss of bowel or bladder control, or a head injury with vomiting or worsening confusion is an emergency room trip right now, not a call to a clinic. During pregnancy, add to that list any bleeding, leaking fluid, contractions, abdominal pain, a change in the baby's movement, or a direct blow to the belly: those are immediate calls to your obstetric provider or emergency services, never a clinic booking.

If none of that is present and what you have is a stiff neck and a dull headache that eases as you move, you are in clinic territory, after your OB has cleared you.

A made bed in early light with a long body pillow laid along one side and a folded blanket at the foot — A neck that hurts to turn meets a body that is only allowed to sleep side-lying. The pillow does a lot of work. Photograph made for this desk.

What pregnancy changes here

Three things. First, the decisions about imaging and medication are narrower and they are not yours or a chiropractor's to make alone; your OB has a view on both, which is why their clearance comes first and why the clinic should hear what they said. Second, sleep is already constrained. A neck that does not want to turn meets a body that is only allowed to lie on one side or the other, and the combination makes the second and third nights the hardest part of the week. Third, the ordinary neck strain of pregnancy, from side-lying and from looking down more, is already present, so the exam's job is to separate what the crash did from what was there before. The earlier it happens, the cleaner that separation.

What to watch and write down

How far you can turn your head each direction, in plain terms: to the shoulder, halfway, barely.
The headache: where it sits, when it is worst, whether it is easing or growing day over day.
Any tingling, numbness, or weakness into an arm or hand. Worth a call the day it appears.
Dizziness, especially on standing, which you have also told your OB about.
Sleep: which side, how many pillows, how many times you woke.

At the clinic, say both things

Say neck and say pregnant. Tell them where the headrest was, where the belt was, and whether your head hit anything. Tell them what your OB said. The visit should produce an exam of the neck and upper back, findings in writing, and a plan you can repeat out loud, including what they will not do because you are pregnant. Missouri Injury Clinic takes auto-injury patients at three rooms: O'Fallon (636) 280-0990, Hazelwood (314) 627-1411, South County (314) 530-5480. Closed 12 to 2 daily. The getting seen page covers the call and the visit.

What this page isEducational reading, not medical advice and not a diagnosis. Your obstetric provider leads during pregnancy; take every question about what is safe for you and the baby to them first.

A stiff neck and a headache are a reason to be examined, not a reason to wait.

After your OB has cleared you, call the room you can reach this week. Say neck, say pregnant, say the date.

Get checked this week (636) 280-0990Lake St. Louis (O'Fallon)