Whiplash

Written on the 17 October 2014 by Active Body Physiotherapy

Throughout your lifetime it is likely that you will be involved in a car accident at some stage, some will be more severe than others but hopefully they will be minor and injury free. However, even if the accident is minor, you can still suffer from something called Whiplash or Whiplash Associated Disorders (WAD). Whiplash injury is the most frequently recorded injury among compulsory third party personal injury claimants in NSW. Whiplash is involved in approximately 45 per cent of all claims.

What is Whiplash?

Whiplash occurs when someone’s head moves forwards and then backwards quickly. This quick back and forth movement may cause injury to the neck. This whiplash movement often occurs in car accidents, however, this is not the only scenario it can occur, these sorts of injuries can also occur in sporting scenarios.

People often experience neck pain and stiffness afterwards, sometimes not until a few days following the accident. For most people, the pain is mild and does not interfere with their normal activities. However, some people’s recovery is slower especially if the injury is more severe.

Research indicates that people who carry on with their normal activities recover faster than people who stay at home and reduce their activities.

Neck pain is the most common symptom associated with a whiplash injury. However, some people have more severe neck pain than others. People with whiplash may also experience headaches, pain in the shoulders and arms, dizziness or altered sensation, for example, pins and needles, weakness in the arms.

A registered health professional such as your GP or Physiotherapist is the best person to advise you about how to manage your WAD.

An “active” recovery in which you continue your normal activities is the best way to recover. If you have had to reduce your normal activities, you should be able to return to them within weeks.

Pain is a normal reaction to being hurt. Pain during the recovery period of your injury does not necessarily mean that further injury is occurring.  Studies have shown that patients who received active intervention have significantly reduced pain intensity and sick leave at 6 months and 3 years respectively. In addition, patients receiving early active intervention had a total neck range of motion similar to that of matched uninjured people at 3 year follow-up.

What can I do to help me get better?

Gentle neck exercises to restore movement, flexibility and to ensure that the muscles are acting to support your neck. These exercises will be prescribed to you by your Physiotherapist.

Try to stay active. Do as many of your normal activities as possible.

Stay at work if you can. People who stay at work after an accident recover more quickly than those who take time off.

Don’t use a collar without advice from your doctor or physiotherapist. Collars used to be standard protocol for Whiplash injuries, however, the new evidence shows that active recoveries are much better and wearing a collar is unnecessary and often makes your recovery slower unnecessarily.

Tips for Managing Daily Activities.

Avoid any unnecessary strains on your neck.

Initially avoid heavy lifting. Divide heavy loads into several lighter loads for carrying.

When sitting, change your posture regularly, stand up for a break at regular intervals and perform gentle exercises regularly throughout the day.

Ensure correct seat setup and sitting posture when at work, sitting at computer, driving, etc.

Spread out tasks and rotate them to prevent over straining

Bring tasks closer to you. For example, lower the clothes line to reduce the strain on your shoulders and neck while hanging out the clothes, kneel to weed the garden rather than bending over.

What shouldn’t I do?

As discussed above, an active recovery will ensure you have the best and fastest results in getting back to a regular, pain-free life. It is best to avoid periods of bed rest, collars are no longer considered useful in the treatment of whiplash and actually delay recovery and you should try not to cease your activities of normal daily living, as long as they are not causing severe and debilitating pain.

Exercise will help

Exercises will be prescribed to you by your Physiotherapist. These exercises will be focused on restoring movement and muscle control around your neck and to reduce any unnecessary postural strain and muscle pain. They should be performed in a slow and controlled manner.

With any exercises, if you experience any of the following symptoms stop and contact your doctor/physiotherapist: dizziness, light headedness, blurred vision, fainting or disorientation, sudden pain shooting down your arm, or numbness or weakness in your arm or hand, unusually severe neck pain, exercises consistently producing a headache, which persists.

You should expect some level of discomfort but remember exercises should not cause severe pain.

Do I need an x-ray?

Following a MVA, your GP/Physiotherapist should send you for an x-ray if you are:
- 65 years of age and over
- “Dangerous mechanism” (high speed > 100km/hr, rollover or ejection, recreational vehicle or bicycle crash)
- Unable to rotate your head 45° to the left and right

What about an MRI/CT scan?

At the time of initial presentation, MRI is not indicated because of high false positive results. CT and MRI are generally reserved for patients with suspected disc or spinal cord injury, fracture, or ligamentous injury. CT and MRI may also be indicated in patients with long term persistent arm pain, neurologic deficits, or clinical signs of nerve root compression.

When should I start Physiotherapy? What will Physiotherapy involve?

The first three months post injury is the most crucial timeframe for physiotherapy. As soon as you are able to get yourself to a Physiotherapist post-MVA, the better off you will be.

Your physiotherapist will assess your injury, give you advice and education regarding the injury/whiplash and what you can do to improve it, soft tissue release work, passive joint mobilisation, traction, dry needling/acupuncture, heat and/or ice, prescription of stretches/exercises to restore movement and muscle control.

TAKE HOME MESSAGE:

- See a Physiotherapist as soon as you can, if your GP tells you there is nothing Physiotherapy can do for you, you can point them towards doing some research on recent literature and what NSW Motor Accidents Authority is advocating in order to educate themselves ;) http://www.maa.nsw.gov.au/default.aspx?MenuID=115
- DO NOT wear a collar, put yourself on extended bed rest and cease all activities.
- Try to stay as active as you can without causing severe debilitating pain.
 

Rebecca Gonzalez
Physiotherapist
M.PHTY;B.ExSc