Whiplash injuries can result in significant amounts of lost work productivity, medical care, and legal services, making it one of the most costly musculoskeletal conditions to treat in the United States at roughly $29 billion dollars per year.
Dr. Curtis wrote this great article highlighting several key points. We can help with your pain – and you can reach out to us using the form to the right- One of our doctors will get right back to you!
Symptoms of Whiplash include:
- Neck pain or stiffness with a loss of active range of motion
- Headache
- Radicular symptoms
- Cognitive impairments
- Sensorimotor symptoms:
- Altered patters of muscle recruitment
- Altered postural control mechanisms:
- Kinesthetic sense
- Balance
- Eye movement control
Structures in the neck that can be injured with a Whiplash injury:
- Facet joints
- Nerve roots
- Ligaments
- Cervical discs
- Muscles
Trigger points in the muscles of the neck and shoulders likely contribute to your pain16 following a Whiplash injury. A trigger point is a hypersensitive spot within a taut band of muscle that refers pain to a distant location17. We have an amazing way to calm these down immediately, and you can read about it here.
Studies find that patients with Whiplash have more trigger points in the neck and shoulder muscles than normal subjects.
The specific muscles with a higher prevalence of trigger points are:
- Upper Trapezius
- Suboccipitals
- Levator Scapulae
- Sternocleidomastoid
- Scalenes
The greater the number of trigger points in these patients, the greater their intensity of neck pain and higher self-reported disability. These findings suggest that active trigger points may be an important pain generator in patients with acute Whiplash20.
How Long Does Whiplash Last?
Many Whiplash patients get better with time – usually within 2 to 3 weeks of the injury. Current research, however, is showing that about 50% of people still complain of neck pain even one year after the injury. One study even found that 58% of patients report having symptoms 30 months after.
How can we predict the likelihood of your recovery?
Early identification and getting the right resources for yourself can help.
A Whiplash Clinical Prediction Rule (CPR) was created based on a tremendous amount of collected data from patients with Whiplash injuries and their recovery timelines. This CPR predicts 2 recovery pathways following injury:
- Long-term moderate to severe pain and disability is predicted in individuals with:
- A high level of self-reported disability
- Baseline NDI (Neck Disability Index) score of 40% or greater
- Age of 35 years or older
- A high level of post-traumatic stress
- Hyperarousal subscale symptoms score on the PDS (Posttraumatic Diagnostic scale) of 6 or greater
- A high level of self-reported disability
- Full recovery is predicted in individuals with:
- Age of less than 35 years
- A low level of self-reported disability
- Baseline NDI score of 32% or less
The greatest predictor of your outcome is how you rate your baseline pain intensity – greater than 55/100 predicts a poor outcome
Other predictors of a poor outcome worth mentioning are:
- The presence of low back pain
- Psychological factors such as :
- Negative expectations
- Catastrophizing (making things a bigger deal than they are)
- A Passive coping style (expecting something or someone other than you to make things better)
To me, these last 3 are the most important, because they are factors that YOU can control – you’ll see how next…
What Are the Best Treatment Options for Whiplash?
If all of this talk of poor outcomes wasn’t bad enough, I’ll get the rest of the bad news out of the way now, then we can talk about the bright side…
Once a Whiplash injury becomes chronic, >3 months or so, most treatments have little to no effect.
That’s why, as I stated before, it’s best to identify the problem early on and get to work.
The Best Treatment Options for Whiplash:
- Exercise
Rather than having a passive coping style, you need to be active in your recovery. Being active with gentle exercise leads to better outcomes. And, the higher your pain and disability levels, the more effective exercise is. Good news: the exercise doesn’t have to be intense, and it doesn’t have to be sophisticated…
I usually give my Whiplash patients these few simple exercises to do regularly throughout the day:
- Walk frequently
- Active cervical rotations
- Sit up straight
- Gently and slowly rotate the head side to side in a pain-free range
- Deep Neck Flexor endurance and coordination exercises
- Chin tuck and hold in sitting, supine, and prone
- Chin tuck with rotations
- Wall Slides
- Stand facing a wall
- Slide both arms up and down the wall (with a towel) slowly and in a pain-free range
2. Psychological counseling
Remember I shared with you earlier that negative expectations as well as catastrophizing tend to lead to poor outcomes following a Whiplash injury, right? You also saw that Post-traumatic stress leads to poor outcomes.For these reasons, even simple advice to improve cognitive-behavioral components can have a huge positive impact on your recovery – even equal to that of a comprehensive exercise program.
Here are some important pieces of advice I usually share with my Whiplash patients:
- Try to get back to your normal activities early on
- Perform relaxation techniques
- Deep, slow breathing
- Stress management
- Challenge irrational beliefs
- Remember that 50% of Whiplash injuries improve within a few weeks. Other than age, the only differences between those who get better and those who don’t is related to self-reported disability and self-reported stress
