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Whiplash Treatment & Rehabilitation Guide

What is Whiplash?

Whiplash is a common injury that is caused by rapid acceleration and deceleration of the head and neck. Most injuries involve sprain and strain to the soft tissues (muscles and ligaments). Higher impact whiplash injuries can lead to bony injuries and nerve irritation which may cause pins and needles in your arm. Road traffic incidents are the most common cause of whiplash but it can also occur as a result of a fall or in a collision when playing sport. Most injuries greatly improve over a 2-12 week period. Recovery time depends on the degree of tissue damage, any psychological trauma caused by the injury and the social support that you have.

Symptoms of Whiplash

  • Neck pain or stiffness, headache
  • Shoulder / arm pain, pins and needles or numbness in the arm.

If you have these symptoms you must seek urgent medical assessment:

  • Visual disturbances
  • Hearing difficulties
  • Difficulty speaking or swallowing
  • Gait disturbances
  • Progressively worsening weakness or sensation problems
  • Pins and needles or numbness in the face
  • Blackouts
  • Dizziness
  • Nausea
  • Constant headache
  • Constant pain
  • Pain that wakes you up at night not caused by your position

Whiplash Treatment

A physiotherapist can assess your injury and help you to recover using the management principles of POLICE (protection , optimal loading, ice, compression and elevation). We do not recommend the use of neck collar for whiplash. The best available evidence shows that active exercise/ continuing as normal are the best solutions. Heat , ice and exercise can all help with the management of the pain. As whiplash is often a traumatic event, often fear and stress need to be managed after the injury.

Whiplash Rehabilitation and Neck Mobility Exercises

All whiplash injuries should be checked by a doctor at the accident and emergency department. The doctor will usually fit a soft collar and prescribe pain-relieving medication. As soon as the pain allows, the following exercises should be commenced. These exercises can help reduce the stiffness in the neck and accelerate recovery.

Neck Flexion Take the chin towards the chest, then back up to look forwards.
Neck Extension Move the head back gently and look up to the ceiling, then look forwards.
Rotation to the Right Look over the right shoulder, then back to looking forwards.
Rotation to the Left Look over the left shoulder, then back to looking forwards.
Side Flexion to the Right Look forwards and try to take the right ear to the tip of the right shoulder.
Side Flexion to the Left Look forwards and try to take the left ear to the tip of the right shoulder.

These exercises should be should be repeated 10 times, 3 times each day, if pain allows. Each time the exercises are done, the patient should be able to move the neck a little further. If the pain fails to improve or becomes worse, the exercises should be stopped immediately, and a doctor or Chartered Physiotherapist consulted.

References:

Walton DM, Elliott JM. An integrated model of chronic whiplash-associated disorder. journal of orthopaedic & sports physical therapy. 2017 Jul;47(7):462-71.

Loppolo F. et al. (2014). Epidemiology of Whiplash-Associated Disorders. Springer-Verlag Italia.

Daenen L, Nijs J, Raadsen B, Roussel N, Cras P, Dankaerts W. Cervical motor dysfunction and its predictive value for long-term recovery in patients with acute whiplash-associated disorders: a systematic review. Journal of rehabilitation medicine. 2013 Feb 5;45(2):113-22. [Accessed 14 June 2018]  http://www.ingentaconnect.com/contentone/mjl/sreh/2013/00000045/00000002/art00001?crawler=true&mimetype=application/pdf

ANGST F. et al. (2014). Multidimensional associative factors for improvement in pain, function, and working capacity after rehabilitation of whiplash associated disorder: a prognostic, prospective, outcome study. BMC Musculoskelet Disord., 15, 130.

Sterling M. (2014). Physiotherapy management of whiplash-associated disorders (WAD). Journal of Physiotherapy, 60, pp. 5-12