Headaches in the whiplash syndrome

Spinal Cord. 2001 Apr;39(4):228-33. doi: 10.1038/sj.sc.3101128.


Study design: A prospective clinical analysis of headaches in whiplash injury.

Objectives: To provide a detailed clinical account of the nature, characteristics and natural history of headaches, and to examine their possible relation to the neck injury.

Setting: One medicolegal practice in UK.

Methods: This study consists of a prospective clinical analysis of headache symptoms in consecutive patients referred to the author for medicolegal assessment of whiplash injury, with no special reference to headaches.

Results: All 80 patients noted neck pain. Headaches were related as a consequence of the accident by 48 patients (60% of the total). The circumstances of injury did not differ from whiplash victims who did not have prominent headache. The headache onset was maximum in the first 24 h after injury. The failure to recall well documented pre-accident headaches in almost one fifth of patients is significant. The common types of headaches were non-specific, generalised, dull, aching pain (25 patients), a mixtures of aching and tightness, and tension type headache. Only three (6%) had migraine without aura.

Conclusion: Post-whiplash headache is a genuine common but short lived affair, constant headaches disappearing within 3 weeks in 85% subjects. In the minority complaining of headache after that period there was no evidence of persisting physical injury, nor of inability to work or other disability caused by headaches.

MeSH terms

  • Adolescent
  • Adult
  • Cervical Vertebrae / injuries
  • Female
  • Headache / diagnosis
  • Headache / etiology*
  • Headache / psychology
  • Humans
  • Male
  • Middle Aged
  • Neck Pain / diagnosis
  • Neck Pain / etiology*
  • Neck Pain / psychology
  • Prospective Studies
  • Whiplash Injuries / complications*
  • Whiplash Injuries / diagnosis
  • Whiplash Injuries / psychology