Cervical Strain (Whiplash) Medication

Updated: Dec 02, 2019
  • Author: Warren Magnus, DO; Chief Editor: Trevor John Mills, MD, MPH  more...
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Medication

Medication Summary

The pharmacology of cervical strain involves pain control and palliation. Nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen are mainstays of therapy. Muscle relaxants may prove valuable when treating severe strain injuries to reduce pain and muscle contracture.

One randomized control trial found no benefit in adding cyclobenzaprine to standard ibuprofen therapy. [19]

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Analgesics

Class Summary

For minor strain injuries, oral outpatient analgesics provide adequate pain control. OTC medications also may suffice.

Acetaminophen (Tylenol, Panadol, Aspirin Free Anacin)

Rapidly absorbed from GI tract and distributed widely to all body tissues. Serum half-life is 1-3 h but may be altered in impaired liver function. Posthepatic metabolites excreted in urine.

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Nonsteroidal anti-inflammatory agents

Class Summary

NSAIDs control mild to moderate pain and decrease inflammatory reactions. This entire family of medications may ease pain in strain injuries. Tailor dosage on an individual basis.

Ibuprofen (Ibuprin, Advil, Motrin)

Rapidly absorbed orally and distributed widely through body tissues. Serum half-life is 1.8-2 h. Rapidly metabolized and excreted in urine. Complete clearance of single dose occurs in approximately 24 h.

Ketorolac (Toradol)

Provides effective control of moderate to severe pain, with higher potency than other NSAIDs, which results in more marked GI upset, platelet inhibition, and renal effects.

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Muscle relaxants

Class Summary

These agents provide adjunctive therapy to allow rest, control pain, and aid physical therapy for musculoskeletal injury.

Orphenadrine citrate (Norflex)

Action not well understood, but its analgesic properties make it clinically effective for muscular injury.

Cyclobenzaprine hydrochloride (Flexeril)

Centrally acting skeletal muscle relaxant structurally related to TCAs with similar liabilities. Can be useful adjunct to other therapies for acute musculoskeletal pain.

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