Whiplash - Getting the Best Recovery

Authored by Annette Sim (Titled Musculoskeletal Physiotherapist).

Whiplash refers to a syndrome of neck pain and dysfunction that arises from a traumatic incident such as a car accident, a fall or a contact injury during sport. The usual mechanism of injury involves an acceleration-deceleration force at the neck joints that pushes them into one direction and then into the reverse rapidly.  

Depending on the severity and speed of the incident, the resultant forces could damage the local neck structures, the surrounding joints which include the shoulder and jaw as well as the inner ear system. According to the Guidelines of Whiplash Management 2014, radiographic imaging should only be undertaken if a fracture or dislocation is suspected. In the majority of whiplash injuries, imaging does not help to provide a specific tissue lesion.

The typical signs and symptoms are as: 

• Neck pain and stiffness 

• Headache 

• Jaw pain and stiffness 

• Tingling or pain down the shoulder and arms 

• Dizziness 

• Difficulty focusing on tasks 

• Visual disturbances: double vision, blurred vision  

• Fatigue  

• Impaired head and movement control  

• Psychological distress: flashbacks, nightmares   

Most people with whiplash recover within 3-6 months. However, research has demonstrated 50% of people who sustained a whiplash injury report long term disability and impaired function without proper rehabilitation. In the past, neck collars were a common recommendation, but the latest research evidence has shown that long term neck collar usage causes the neck muscles to weaken which further aggravates neck pain. Staying active is important in the recovery of whiplash but an appropriate gradual return to normal daily activities as well as recreational sports needs to be taken. Other times, medications with combination of active exercises can facilitate functional improvements.  

A physiotherapist will assess the impairments from the local muscle, ligamentous and joint systems around the injured areas. Specialized assessments for the inner ear system or visual disturbances are completed if required. From the assessment findings, an individualized exercise program will be constructed. Exercises can include range of motion actions, low load isometric holds, postural endurance and strengthening exercises. Appropriate treatment utilising manual therapy, taping or dry needling can also be used to optimize recovery as well. An exercise program that includes gradual pacing of activities for work and sports can also be developed by your physiotherapist. 

Annette Sim is an APA Titled Musculoskeletal Physiotherapist who works at Lifecare Prahran Sports Medicine on Tuesdays, Thursdays and Fridays.
The clinic is close to suburbs including Malvern, South Yarra, Toorak, Armadale, St Kilda East, Caulfield, Richmond and Hawthorn, and has early and late appointments for all your Sports Medicine and Physiotherapy needs.

 

1) L. Carroll, L. Holm, S. Hogg-Johnson, P. Cote, D. Cassidy, S. Haldeman. (2008). Course and prognostic factors for neck pain in whiplash-associated disorders (WAD): results of the bone and joint decade 2000–2010 task force on neck pain and its associated disorders, Spine, 33:583-592.  

2) Guideline for WAD: State Insurance Regulatory Authority: Guidelines for the management of acute whiplash-associated disorders – for health professionals. Sydney: third edition 2014.   

https://www.sira.nsw.gov.au/resources-library/motor-accident-resources/publications/for-professionals/whiplash-resources/SIRA08104-Whiplash-Guidelines-1117-396479.pdf 

3) W. Spitzer, M. Skovron, L. Salmi, J. Cassidy, J. Duranceau, S. Suissa. (1995).Scientific monograph of Quebec Task Force on Whiplash associated disorders: redefining “whiplash” and its management, Spine, 20(8 Suppl): 1S-73S. 

4) Sterling M (2014) Physiotherapy management of whiplash-associated disorders (WAD). Journal of Physiotherapy 60: 5-12]  

 https://www.sciencedirect.com/science/article/pii/S1836955314000058#bib0185 

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