More than 600 people were on the Lahore-Rawalpindi train when it derailed near Jhelum. Officials suspect sabotage.
At least three people died. Officials say it is a miracle casualty figures are not higher given the scale of the derailment.
Troops had to use another train to access the remote crash site, which is inaccessible by road.
Nasreen Naveed and her son Hassan were among 40 injured and taken to hospital in Jhelum.
Federal railway minister Ishaq Khakwani says preliminary investigations suggest the track was tampered with.
Authorities say nuts and bolts from a large portion of track near a sharp bend had been removed.
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