What Is Whiplash?
Whiplash is an acceleration-deceleration injury that generally occurs as a result of a rear end or side impact car accident. It is a very prominent issue that can affect victims of a car accident as a direct result of another driver’s negligence. In Australia, there are 106 cases for every 100,000 people in the population, most commonly leading to injury of the upper cervical spine.
Symptoms of The Condition
Common symptoms of whiplash injuries include pain, stiffness, paraesthesia, headache, poor coordination, dizziness, nausea, and impaired brain function. 60% of people with whiplash also report lower back pain. These can significantly affect an individual’s quality of life, and without appropriate treatment, can worsen into further pain and other chronic problems.
In order to identify the appropriate treatment needed for each individual case of whiplash, an accurate diagnosis by a physical therapist or a physician must first be made. This is done using the Quebec Classification scale that ranges from grade 0 (no neck complaint or physical signs) to grade IV (neck complaint and fracture or dislocation).
Treatment of Whiplash
The most common type of passive/manual treatment for whiplash injury will be physiotherapy or chiropractic treatment. This is often followed by an active exercise program, where the sufferer learns exercise techniques to reduce their discomfort and strengthen the relevant muscles in the affected area. This is often complemented by Non-Steroidal Anti-Inflammatory drugs (NSAIDs) and other pain-relieving medication. Whiplash is classified by medical professionals as either acute (for up to 12 weeks) or chronic (after 12 weeks). Acute injuries can become chronic without appropriate treatment or if the individual suffers further damage.
Acute Stage (0-12 weeks)
Most cases of whiplash resolve within the acute stage due to physical management options. Exercise and activities have been considered as effective treatments for whiplash, whereby victims aim to return to normal levels of activity and exercise as opposed to being immobile, although this is still debated. Exercise and activity are reported to be particularly effective when used in combination with manual therapy, which is recommended.
Chronic Stage (12+ weeks)
Both education and advice are important for victims suffering the long term ramifications of whiplash. For example, offering information on the mechanisms of their injury or prognosis, as most victims will appreciate their pain being explained. Discussing their activity levels and offering reassurance is also important.
As with acute considerations, chronic patients must also be encouraged to gradually return to normal levels of exercise and activity, and undertake manual therapy. Although in chronic cases this has been proven to only reduce the pain rather than removing the problem in the long term.
Regardless of whether a victim is in the acute or chronic stage of whiplash, a physical therapist is likely to assign them physical exercises to promote recovery and reduce any pain the individual may be experiencing.
Exercises include general stretches of the affected area, as well as Assistive Range of Motion (AROM) exercises. These are done to preserve the flexibility and mobility of the joints on which they are performed. They reduce stiffness and will either prevent or slow down the freezing of a victims joints following their likely immobility after a crash.
The term ‘range of motion’ describes the amount of movement you have at each joint in the body. Joints are classified as different types, and each has a “normal” range of motion. Regular exercise, activity and movement help to maintain the normal range of motion in a particular joint. It is therefore very important to try to gently move your joints following a whiplash injury, as stiff ones can cause pain, making it hard for a victim to continue with their daily activities after a crash.
Postural retraining is also an option. This addresses repetitions, habits, and structural positioning to correct any imbalance that may be caused by whiplash. A specialist will coach a victim through proper body alignment, using the bodies “landmarks” to assess each individual’s alignment and track progress. Following this, further exercises, stretches, and postures will be assigned to improve the efficacy and lasting results of the treatment.
Physical therapists may also look to strengthen neuromuscular control after a crash. They focus on muscles around the head, neck, back and spine in particular. For example, the deep neck flexors, the shoulder muscles, and the scapula muscles.
Long Term Ramifications of The Injury
Without appropriate treatment, the symptoms of whiplash can persist. Luckily, over half of victims report that symptoms subside after one month, and that they are pain-free after just three months. 75% of people fully recover within 6 months, and 85% of people fully recover within 3 years.
However, 15% of people continue to report symptoms after 3 years, suggesting that there is a more chronic problem that requires treatment. Furthermore, 4% of victims continue to report pain of a severe level after 3 years. Not wearing a seatbelt, amongst other factors, is one of the main reasons behind chronic whiplash.
There are also psychological impacts associated with long term whiplash including helplessness, fear of moving, anxiety, depression, post-traumatic stress reaction, and low self-efficacy.
Should you, or someone close to you find themselves suffering from suspected whiplash after a crash it is important to visit a physical therapist as soon as possible in order to diagnose the issue. The physical therapist will recommend the best line of treatment for each individual that will both reduce the pain and treat the problem, therefore increasing the quality of life for each victim.
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