OUTLINE OF WHIPLASH TREATMENT

Whiplash treatment in the past often involved a recommendation for rest and immobilisation in a cervical collar however the current recommended therapy tends to encourage early movement and gentle exercise. Soft collars are now rarely recommended except in cases of more serious injury and even then are usually used only for the short term and on an intermittent basis. Doctors frequently recommend physical activities including walking and aerobic or isometric exercises to improve mobility. An early return to work is encouraged with, if necessary, temporary modifications in the type of physical work to be carried out.

The mechanism and nature of whiplash injuries is clearly understood, however the extent and type of injuries vary. Symptoms resolve within a few months for most people but in some rare cases the condition may become chronic with permanent long term residual symptoms. These injuries are always investigated further and occasionally need surgical intervention. This injury which is also known as cervical acceleration/deceleration trauma or syndrome most commonly causes serious and lingering neck pain, often associated with back pain, headaches and dizziness. Bruising of the brain may occur in severe cases and occasionally there is blurred vision, ringing in the ears, nausea and numbness.

Whiplash treatment may include:

• use of painkillers, anti-inflammatories, or muscle relaxants;
• immobilisation using a soft cervical collar;
• physiotherapy including the use of ice, moist heat, ultrasound, exercise and electrical stimulation;
• anaesthetic injections may help alleviate pain and tenderness;
• cervical traction;
• surgical intervention in severe cases involving persistent pain which may indicate a tear in an intervertebral disc. Once the disc is removed then spinal fusion may be necessary to permanently join two or more vertebrae:

Inflammation and painful muscle spasms can be reduced by applying ice or an ice pack to the injured area for about 15 minutes every hour. After the first 24 hours it can be beneficial to alternate cold packs with heat treatments including warm towels or a heat lamp which can be used to soothe the neck for 10 minutes several times a day. Gentle massage can be a beneficial therapy and current medical opinion on whiplash treatment advises ensuring moderate mobility of the neck as soon as possible after the accident.

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