By Physiotherapist Jordan Coffey.
Whiplash Associated Disorder (WAD) is the most common injury associated with motor vehicle accidents. WAD affects up to 83% of patients involved in collisions and in more serious cases can lead to chronic disability. Most patients recover within 2-3 weeks following the injury. However, a significant proportion of WAD patients (up to 42%) transition from an acute to chronic presentation. However, chronic WAD patients present with a far more complex clinical picture characterized widespread sensory hypersensitivity and posttraumatic stress reactions. (4)
According to the Quebec Task Force Classification of Grades of Whiplash Associated Disorders, Whiplash is defined as “as an acceleration-deceleration mechanism of energy transfer to the neck. It may result from … motor vehicle collisions. The impact may result in bony or soft tissue injuries (whiplash injury), which in turn may lead to a variety of clinical manifestations (Whiplash-Associated Disorders).” (1) Whiplash is categorized into 5 separate categories which reflect the degree of severity of the condition, symptomology experienced by the patient, and signs gathered by professionals during assessment.
Interestingly enough, Whiplash may also occur as a result of injury in contact sports, such as football tackles and other sports-related collisions. (2) In some cases, Whiplash can result as a result of physical abuse or assault. It is highly important to be aware of the causes, signs, and symptoms of WAD in order to know when to seek professional help and optimize recovery.
As a result of high impact force, whether it be a motor vehicle accident, sporting injury, or punch to the head, the neck is forced into non-physiological motion. Energy is then stored in the elastic components of the cervical spine, followed by an abrupt release of energy and subsequent forward thrust of the head and neck. This “acceleration/ deceleration of the head/neck and torso” is demonstrated in Image 1 below. This release of energy may impact and injure anatomical tissues in the cervical spine, (e.g. intervertebral discs, joint capsules, ligaments, facet joints, muscles, and nerve tissues).
Image 1: Acceleration/ deceleration of the head/neck and torso
So, what can we do to assess and treat WAD?
The NHMRC has outlined a series of “Grade A” and “Grade B“ recommendations, meaning that the evidence outlined can be trusted to guide clinical practice and in most clinical situations, for assessment and management of WAD. The summary of recommendations is listed below:
Assessment
- CT scans and MRI’s are NOT required in WAD grade I and II
- Degenerative or minor pathological changes on X-ray, MRI, and CT are NOT associated with ongoing disability and pain in WAD
- Age, gender, marital status and education are NOT predictive of ongoing pain/disability
- >5/10 pain intensity of the VAS (visual analogue scale) and >15/50 score on the NDI (neck disability index) are associated with a poorer prognosis and may require earlier referral to a specialized clinician (3)
Treatment
- Stay active to optimise recovery from acute WAD
- Symptoms are a normal reaction to being hurt
- Focus on improvements in FUNCTION
- Voluntary restriction of activity may cause delayed recovery
- Paracetamol and NSAIDs may be used for the treatment of acute WAD
- EXERCISE is recommended – range of motion exercise, low load isometric, postural endurance and strengthening exercises
If you are currently suffering or have recently suffered from neck/upper back pain secondary to a motor vehicle accident, hard tackle during a sports match, or hit to the head, book an appointment with one of our Physiotherapists at 4Lane Physiotherapy to help alleviate your symptoms and devise an individualised rehabilitation program.
Who should I book with?
All of our Physiotherapy team are qualified to help you with your whiplash injury. Your Physiotherapist will guide you on the treatments needed as such as home exercise, taping, massage and or dry needling.
Call 9756 7424 or alternatively book online today
Cancellation Policy
We have a same day cancellation policy where a $50 fee will be charged for missed or cancelled appointments. Please call 9756 7424 or email info@4lane.com.au to reschedule or cancel Thank you for your understanding.
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Sources:
Spitzer, W.O., Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: Redefining ‘whiplash’ and its management. Spine, 1995. 20: p. 1-73.
Brukner, P., Clarsen, B., Cook, J., Cools, A., Crossley, K., Hutchinson, M., … Khan, K. (2017). Brukner&Khan’s Clinical Sports Medicine (5th ed., Vol. 1). Sydney, Australia: McGraw Hill Education.
Journal of Orthopaedic & Sports Physical Therapy, 2013 Volume:43 Issue:2 Pages:31–43 DOI:10.2519/jospt.2013.4507.
Journal of Orthopaedic & Sports Physical Therapy, 2009 Volume:39 Issue:5 Pages:312–323 DOI:10.2519/jospt.2009.2826.