Kinesis Physical Therapy South Hills, Pittsburgh, PA

Whiplash & Physical Therapy

What is Whiplash?

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Whiplash injury involves an acceleration/deceleration energy transfer to the neck, which may result from a rear-end or side impact motor vehicle collision.1  This type of injury can also be sustained diving into a pool or being tackled.  Typically, whiplash injury to the neck involves relatively minor soft-tissue damage, but in severe cases it can involve fracture.2   Whiplash associated disorder (WAD) is the clinical manifestation of a whiplash injury and presents as a number of symptoms.   The following are common symptoms with the corresponding percentage of people who experience them within 4 weeks of a whiplash injury.3

  • Neck pain (90-100%) Whiplash & Physical Therapy
  • Decreased neck mobility (40-95%)
  • Headache (50-90%)
  • Sensitivity to light (30-80%)
  • Shoulder & arm pain (40-70%)
  • Dizziness (20-70%)
  • Concentration problems (20-60%)
  • Fatigue (60%)
  • Fear (45-50%)
  • Reduced vision (20-45%)
  • Depressive complaints( 45%)
  • Back Pain (35%)
  • Insomnia (35%)
  • Increased irritation(20%)
  • Abnormal sensation in the hand (10-15%)

Incidence and Prognosis

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The incidence of this injury has been reported to be as high as 188 per every 100,000 people a year.3  The prognosis is thought to be generally favorable.1  Up to 25% of people recover within one week and 98% after a year.4
 

Physical Therapy After Whiplash Injury

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Early referral to physical therapy has been shown to be more effective than immobilization and rest.5,6,7  There are instances when immobilization may be warranted such as in the case of a potential fracture or possibly during the first few days after the injury.

 
Physical therapy is typically recommended and may include:
  • Manual physical therapy8
  • Exercise 9
  • Encouragement by the therapist to participate in normal daily activities 10,11,12
  • Modalities such as electrical stimulation and moist heat 
Symptoms may not occur immediately but if they do a medical practitioner should evaluate them.  Early intervention with physical therapy can result in better outcomes in the short and long term.5,6,7.
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Author: Christopher (C.J.) Eberley, PT, DPT
Board Certified Orthopedic Physical Therapist
 
Disclaimer: The views discussed on this website are for educational purposes only. Should you have any questions please consult your physician or physical therapist. Copyright© Kinesis Physical Therapy. All Rights Reserved.
References
1. Spitzer WO, Skovron ML, Salmi LR, Cassidy JD, Duranceau J, Suissa S et al. Scientific monograph of the Quebec Task Force on Whiplash-associated disorders: redefining ‘Whiplash’ and its management. Spine 1995;20:7S-58S.
2. Scholten-Peeters GG, Bekkering GE, Verhagen AP, et al. Clinical practice guideline for the physiotherapy of patients with whiplash-associated disorders. Spine 2002;27:412–22.
3. Stovner LJ. The nosologic status of the whiplash syndrome: a critical review based on a methodological approach. Spine 1996;21:2735-46
4. Harder S, Veilleux M, Suissa S. The effect of socio-demographic and crash-related factors on the prognosis of whiplash. J Clin Epidemiol 1998;51:377-84.
5. Mealy K, Brennan H, Fenelon GC. Early mobilization of acute whiplash injuries. Br Med J, Clin Res Ed 1986;292(6521):656-7
6. Rosenfeld M, Gunnarsson R, Borenstein P. Early intervention in whiplash-associated disorders: a comparison of two treatment protocols. Spine 2000;25(14):1782-7.
7. Rosenfeld M, Seferiadis A, Carlsson J, Gunnarsson R. Active intervention in patients with whiplash-associated disorders improves long-term prognosis: a randomized controlled clinical trial. Spine 2003;28(22):2491-8
8. Fernandez de las Penas C, Fernandez-Carnero J, Fernandez A, Lomas-Vega R, Miangolarra-Page J. Dorsal manipulation in  whiplash treatment: a randomized controlled trial. Journal of Whiplash and Related Disorders 2004;3:55-72
9. Jull G, Trott P, Potter H, et al. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache.  Spine 2002;27(17):1835-43; discussion 43.
10. Borchgrevink GE, Kaasa A, McDonagh D, Stiles TC, Haraldseth O, Lereim I. Acute treatment of whiplash neck sprain injuries. A randomized trial of treatment during the first 14 days after a car accident. Spine 1998;23(1):25-31.
11. Ferrari R, Russell AS, Richter M. Epidemiology of whiplash injuries: an international dilemma. Orthopa. 2001;30(8):551-8.
12. McClune T, Burton AK, Waddell G. Whiplash associated disorders: a review of the literature to guide patient information and advice. Emerg Med J 2002;19(6):499-506