What is whiplash?
Whiplash itself is not an injury or a diagnosis. The term “whiplash” refers to a sudden jerking or jolting of something (usually refers to the head/neck). It is commonly used to describe what happens in a car accident when you are moving very quickly and suddenly stop, such as driving into a stationary object, or when you are stationary and another car quickly hits you from behind.
The associated injuries, pain and dysfunction that follow this incident are referred to as Whiplash Associated Disorders or WAD. However, it is commonly still described and diagnosed as simply “whiplash”.
Whiplash Associated Disorders:
Whiplash Associated Disorders occur after there is a sudden acceleration then deceleration force to the neck as mentioned above. This can affect the muscles, ligaments and even the bones in that region.
Whiplash injuries vary greatly in severity, sometimes symptoms last only a few days to weeks and can be treated with simple physiotherapy techniques to manage the pain. However, fifty percent of those who suffer from WAD will still have symptoms three months later. Treatment and rehabilitation in these cases then become extremely important to ensure there are no lasting effects, you can achieve your goals and be pain-free.
Whiplash is often associated with motor vehicle accidents as this the most common cause. However, it can occur from many other scenarios where the neck is forcefully moved backward and forwards, or side to side, such as:
- Motor vehicle accidents
- Sporting injuries involving a collision
- Falls involving the neck or head
- Forceful theme park rides
- Bungy jumping
Symptoms of whiplash-associated disorders
- Neck pain and/or stiffness
- Reduced range of head movements
- Tenderness around neck and shoulder muscles, or the spine
- Headaches, dizziness and other concussion symptoms
- Changes to sensation through arms or around shoulder blades
- Weakness through arms
How is it diagnosed?
The assessment of whiplash can in most cases be completed by a physiotherapist. The Transport Accident Commission (TAC) provides a whiplash guideline to increase the accuracy of diagnosis. It is based on the mechanism of injury, current symptoms, and a thorough physical examination. This usually involves palpation of the spine and surrounding areas, testing movement, and muscle strength, and assessing sensation and reflexes.
In most cases, scans, such as x-rays, are not required. In fact, they are only suggested if a fracture is suspected (which is rare). Otherwise, they do not alter the treatment you would receive after a whiplash injury.
What does the treatment involve?
Based on the Transport Accident Commission’s guidelines, treatment would involve:
Active exercise
Exercise is the most effective treatment for whiplash-associated disorders. There is high-level evidence supporting the use of exercises to strengthen the neck, shoulders, and back following a whiplash injury. These should be gradually introduced and increased based on an ongoing assessment from your Back In Motion physiotherapist.
Understanding the injury
Understanding an injury and what you can do to help yourself is a key component to recovery. Incorrect and often negative beliefs about pain, as well as excessive cautiousness, can result in worsening symptoms, even when the initial injury is improving.
Spinal mobilization, massage, and other passive treatments
‘Hands-on’ treatments are recommended only if they show benefits, such as you have increased movement or reduced pain afterward. This includes the use of heat or ice. ‘Hands-on’ treatment also must be accompanied by specific ongoing exercises. Often hands-on treatments are used more frequently at the beginning of a whiplash injury and then reduces in frequency with time.
Pain medication
Simple painkillers and anti-inflammatories can be used to reduce pain in the short term. They are not suggested as an ongoing treatment for persistent pain. This should be discussed with your doctor or pharmacist.
What is the BEST management for WAD?
Early intervention
We recommend seeing your GP or physiotherapist if you think that you have suffered from whiplash. Whiplash symptoms can often develop after a few days, so it is important that you seek treatment and advice even with a seemingly minor injury. Early treatment is essential in controlling whiplash and improving the likelihood and speed of recovery. Exercise is the key.
Stay active
While pain and injury sometimes require rest, complete rest following a whiplash injury is not recommended. Often fear and being over cautious can result in an increase in symptoms. Instead, gradually return to your usual tasks and focus on what you can do. In addition to this, soft collars that immobilize the neck are not recommended unless medically necessary (e.g. fractures).
Imaging is very rarely required
As mentioned above, imaging is not a routine part of assessing whiplash. Findings such as degeneration on x-rays are often incidental and do not correlate with poor outcomes following a whiplash injury.
The correct management of whiplash soon after it has occurred is crucial and can greatly affect prognosis. Whiplash is often seen by our physiotherapists at Back in Motion Mentone, and all our physiotherapists can accurately diagnose and treat the condition.
If you sustained your injury in a car accident, some or possibly all of your treatment cost may be covered by the Transport Accident Commission. Give us a call, or book in online at Back In Motion Mentone, for a free initial assessment and to get started early on the management of your condition.
Author:
Zebulun Ariaratnam
Clinical Service Co-ordinator & Physiotherapist