WHIPLASH TREATMENT

Whiplash treatment has traditionally been conservative, consisting of rest, analgesic (anti-inflammatory) medications, heat therapy to relieve muscle tension and pain and muscle relaxants for 2 to 4 weeks. In cases of severe pain, oral narcotic medications also may be used for a short course (7 to 10 days). Use of narcotics for longer periods puts patients at risk for development of tolerance.

Immobilisation of the neck with use of a soft cervical collar (neck brace) for 2 to 4 weeks also has been recommended but recently has been called into question by some doctors. In one medical study comparing use of a neck brace and analgesic medications with a regimen of active therapy, the group treated actively had significant improvement in both neck pain and mobility compared with the group treated with a neck brace.

The current trend in whiplash treatment seems to be to encourage early movement, rather than immobilisation. The soft collar may be used for a short term and on an intermittent basis. Your doctor may provide you with a series of exercises that you can do at home. An early return to work is encouraged, even if your doctor must prescribe some temporary modifications in your work situation.

Acupuncture

Treatment of the neck area with acupuncture has been known to provide short-term pain relief, only a few people get more long lasting relief.

Chiropractic

Chiropractic treatment is considered best for the first 12 weeks and for lost range of motion in sub-acute and chronic cases. Chiropractic manipulation is contraindicated in patients who exhibit abnormalities on neurological examination, radiographic studies or both.

Injections

This form of treatment may be useful when there are pinched nerves and/or herniated discs.

Massage

May ease muscle spasm and tightness. Some long term relief is possible, but mostly short-term.

Physical Therapy

Physical therapy may be useful when there is lost range of motion, and stiffness.

Surgery

When there are herniated discs that can't be treated conservatively, surgery may be considered as a last resort.

Whilst most patients recover within a couple of weeks, a small number continue with long-term discomfort, pain and movement limitation. If symptoms continue or worsen after 6 to 8 weeks, further x-rays and other diagnostic testing my be necessary to see if the patient suffered a more severe injury. Factors that may be associated with a poor prognosis include a previous history of neck pain, neck stiffness, thoracolumbar pain, muscle spasms, paresthesias, presence of objective neurological signs, and an abnormal cervical spine curvature on x-ray films.

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