Whiplash - A Background And Summary Of Recommendations

What is Whiplash?

Whiplash associated disorders are defined as an acceleration-deceleration mechanism of energy transfer to the neck. The typical result is bony or soft tissue injury. The most common causes of whiplash associated disorders are motor vehicle accidents, particularly when hit from behind. This causes a rapid flexion- extension - flexion whipping action of the neck. Other less common causes are collision injuries and sports injuries in contact games.

What are the grades of severity?

A classification system has been devised to grade the severity of whiplash associated disorders. The grades range from 0 to 4 and include the following:

Grade 0: No complaint of symptoms with no physical signs

Grade 1: Complaint of neck pain, stiffness and tenderness with no signs

Grade 2: Complaint of neck symptoms with musculoskeletal signs of reduced range

Grade 3: Complaint of neck symptoms with neurological signs of weakness and sensory deficits

Grade 4: Complaint of neck symptoms and fracture/dislocation present

How should I be managed?

A physiotherapist is able to assess your injury status and determine what classification level you fall under to ensure you receive the most effective and specific treatment. It is important that patients realise that physical serious injury with higher grades is actually quite rare and the majority of patients have an extremely good prognosis. Reassurance and the adoption of a positive attitude early on are central to a good outcome.

Common management of whiplash associated disorders includes:

Correct advice on activity modification e.g. appropriate work and recreational schedules to ensure you do not aggravate your symptoms but still remain active. Recovery is actually improved with graded early return to normal pre accident duties with bed rest and neck collars actually contributing to delayed recovery and chronicity.

Prescribe an effective muscle re-education exercise program to restore appropriate muscle control and support in the neck region. Self exercises have been shown to help regain normal activity levels quicker as well as reducing neck symptoms.

Correct advice on pain management strategies. Over medication has been shown to be detrimental to recovery. Your physiotherapist is able to show you the best, non pharmacological methods of pain relief to help to get back to normal activities pain free as quick as possible but also empower you to cope better with symptoms.

McClune et al 2002 Emerg Med J 19:499-506

Summary Guidelines for the management of acute WAD Motor Accidents Authority 2007

Sharon Stage is Marketing Manager for Ergoworks. Ergoworks are specialists in the nomic-Consultants
treatment of sports injuries and general Physiotherapy including neck and back physio.

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