Whiplash is an injury that typically occurs in a motor vehicle accident and involves the quick acceleration and deceleration of the neck. These accidents are often caused by being rear-ended unexpectedly by another vehicle. This type of injury usually involves minor soft tissues of the neck, but in severe cases can involve fracture. Whether your first stop is to the emergency department or to physical therapy, there are highly sensitive prediction rules that these trained professionals can use to identify those that are at a low risk of significant trauma and those that may need further imaging before a plan of care is created.

So, you’ve had an accident and have left the emergency room after an x-ray showed no fracture, but you still have neck pain. Where do you go from here? At this point patients often have more questions than answers about their symptoms and what to expect in the long term.

It is very beneficial to get an assessment from your trusted Physical Therapist to get the answers and proactive plan of care you need to get back to your active lifestyle.

The most important tool for your recovery after these accidents is education on your condition and early movement strategies after a full evaluation has been completed. A Physical Therapist will meet with you to walk through what happened with your body during the accident, symptoms that are common to have at this time, all the body systems that may be involved other than the neck, therapeutic pain neuroscience education, and the most appropriate movements or exercises for you to complete based upon findings during the examination.

Physical Therapists are highly trained, many of which are Doctors of Physical Therapy, and can help you begin your path to recovery, regardless of your starting point. Your care with us at Optivus Physical Therapy will be individualized to you and will not be based upon a “cookie cutter approach” or “no pain no gain.” When you are in our care, you lead the sessions; we simply guide them and empower you to progress as you are able. This means you are in control of what you are comfortable with trying and what you are not.

Common Questions:

  1. When should I go in to see my Physical Therapist and do I need a physician’s referral? This is tricky to answer because everyone is different and presents differently, but if symptoms do not subside within 1-2 weeks it may be very beneficial for you to be assessed by a Physical Therapist. Many insurances do not require a physician’s referral for physical therapy, but there are some that still do. It is always recommended that you reach out to us or to your insurance to see if you need a referral.
  2. How long does it take to recover from whiplash? This varies from individual to individual. At this time, research completed has shown approximately 50% of people have a full recovery within 3 months. Some may have earlier recoveries than this and some may fall just outside this timeframe. Early therapy improves recovery rates and decreases chronicity of symptoms if these are to occur. Your Physical Therapist can talk with you about your prognosis and what results to expect in each phase of healing.
  3. Does physical therapy help with this or should I just take it easy and rest my neck for a while? Physical therapy can be very successful in creating a plan of care individualized for you to get you back to your everyday life! Of course, it may sound biased as I am a Physical Therapist, but according to several research studies there is significant benefit to getting you moving sooner than later. Early referral to physical therapy has been shown to be more effective than immobilization and rest.
  4. What types of things can I expect while I’m at physical therapy? There are many different things that we can do to help alleviate your symptoms. Some of these include gentle passive or active motion, several manual therapy techniques, exercises that directly address your impairments with or without resistance, strengthening of the neck and surrounding area, breaking down functional activities that are important to you until you can fully complete them independently, and addressing other systems as they apply. Some of these systems are: balance, concussion, vestibular/vertigo, nerve pain or numbness/tingling, and many others. The best part: we will show you how to do these at home to continue to progress and take your healing into your own hands as you’re able to!
  5. I have a concussion/dizziness/balance issues/headaches/difficulty sleeping… is physical therapy still appropriate? In most cases, yes, physical therapy is specialized in treating these impairments related to whiplash. We have trained staff to assist in all these areas and have seen exceptional results in improving these symptoms. Each person will be put through a detailed examination and will be treated according to the findings of that therapist. If therapy isn’t the most appropriate place for you, don’t worry, we’ll assist you in finding exactly where you need to go.

A Couple Common Misconceptions:

  1. Characteristics of the collision such as speed, area of impact, and others are predictors of persistent symptoms or severity of pain. False Multiple recent systematic reviews have found that descriptive characteristics of the collision possess little, if any, prognostic value of persistent symptoms or severity of pain. 6,8 This means that someone may have minimal to no symptoms after a higher speed accident and someone at a lower speed accident may have severe symptoms.
  2. I have severe pain, symptoms, and difficulty with activities, I must have damaged my neck pretty bad. False High reports of pain and disability may not necessarily reflect a pure “tissue issue” or “damaged tissue”. Your nervous system can be sensitized immediately and chronically after an accident of this type, which may be contributing to your neck pain and disability. Many Physical Therapists, including all of our Physical Therapists, are highly trained in explaining pain and possible contributors to your limitations after a full examination.

*Note from PT: Car accidents are not the only way whiplash may be sustained. Other potential mechanisms are being tackled, falling, or diving into a pool, for instance.

Disclaimer: The views discussed on this webpage are for educational purposes only and should not be considered medical advice. Should you have any questions please consult your physician or Physical Therapist.

Written by:
Levi Peterson, PT, DPT, ACSM EP
Physical Therapist
Certified Exercise Physiologist

 

References:

  1. Mealy K, Brennan H, Fenelon GC. Early mobilization of acute whiplash injuries. Br Med J, Clin Res Ed 1986;292(6521):656-7
  2. Rosenfeld M, Gunnarsson R, Borenstein P. Early intervention in whiplash-associated disorders: a comparison of two treatment protocols. Spine 2000;25(14):1782-7.
  3. 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
  4. Kamper SJ, Rebbeck TJ, Maher CG, McAuley JG, Sterling M. Course and prognostic factors of whiplash: a systematic review and meta-analysis. Pain. 2008;138:617-629.
  5. Walton DM, Carroll LJ, Kasch H, et al. An overview of systematic review on prognostic factors in neck pain: results from the International Collaboration on Neck Pain (ICON) project. Open Orthop J. 2013;7:494-505.
  6. Casey PP, Feyer AM, Cameron ID. Course of recovery for whiplash associated disorders in a compensation setting. Injury. 2015;46:2118-2129.
  7. Sterling M, Hendrikz J, Kernardy J. Compensation claim lodgement and health outcome developmental trajectories following whiplash injury: a prospective study. Pain. 2010;150:22-28.