I was driving to work, stopped at a red light when, “BOOMF!” - rear ended by a young mother distracted by her toddler in the back seat.  It was a low speed accident.  Only minor dings in our bumpers, and thankfully, no-one hurt.  It’s a pain to get the car fixed but nothing too serious.  But then…

Later that afternoon I gradually developed a really stiff and sore neck.  I couldn’t believe it.  Whiplash.  If I wasn't a physio, it could have been scary.

Whiplash Associated Disorder

Technically called “Whiplash Associated Disorder” (WAD), whiplash is the most common injury from motor vehicle accidents.  46% of all claims made against drivers’ green slip insurance are for whiplash injuries.

Symptoms

Symptoms of whiplash may include: 

• Pain (in the head, neck, back, shoulders or arms)
  
• Stiffness
  
• Pins & needles
  
• Numbness
  
• Dizziness
  
• Tinnitus (ringing in the ears)
  
• Headache
  
• Memory loss
  
• Altered hearing
  
• Jaw pain
  
• Difficulty swallowing
  

Assessment

Depending on your symptoms it may be necessary to see a GP or physio to assess the severity of whiplash.

Your healthcare professional will decide if you need any investigations (ie, scans or xrays - but you most likely won't), ask you a range of questions, and may get you to fill out a questionnaire.

Whiplash is graded 0-IV based on the severity of symptoms (Gd IV being the worst).  

• Gd 0: No complaint about the neck. No physical sign(s).
  
• Gd I: Complaint of neck pain, stiffness or tenderness only. No physical sign(s).
  
• Gd II: Neck complaint AND musculoskeletal sign(s). Musculoskeletal signs include decreased range of movement and point tenderness.
  
• Gd III: Neck complaint AND neurological sign(s). Neurological signs include decreased or absent tendon reflexes, weakness and sensory deficits.
  
• Gd IV: Neck complaint AND fracture or dislocation.
  

Prognosis

Research shows  a range of outcomes for whiplash.  Some people have a fast, full recovery, while others suffer prolonged, debilitating symptoms.  Often it is social and financial variables that influence the progress of recovery.  A strong predictor of outcome is the patient’s own opinion of the severity of the car crash, and their expectation of recovery.

Recommendations

There is a lot of research into the best thing to do for whiplash.  It can be summarised into some very simple advice:

• Reassurance that a range of symptoms are normal
  
• It’s crucial to stay active
  
• “Protecting” the neck by limiting movement will slow recovery
  
• Simple analgesia (such as regular paracetamol) helps promote normal movement
  
• Range of movement exercises provided by your GP or physio are beneficial
  

There are a range of treatments that have been proven to be ineffective in treating whiplash:

• Traction
  
• Pilates
  
• Feldenkrais
  
• Alexander technique
  
• Massage
  
• Homeopathy
  
• Cervical pillows
  
• Magnetic necklaces
  
• Spray and Stretch
  
• Heat
  
• Ice
  
• Transcutaneous electrical nerve stimulation (TENS)
  
• Electrical stimulation
  
• Ultrasound
  
• Laser
  
• Shortwave diathermy
  

And there are some options that are proven to be detrimental:

• Decreased activity
  
• Collars
  
• Muscle relaxants
  
• Injections
  
• Electromagnetic treatment

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So…  lots of movement: up/down, left/right, and my neck and shoulders fully recovered over a couple of days.  Easy.

Here’s a fact sheet about whiplash, produced by the Motor Accident Authority, that is a good reference.

Have you had whiplash?  What was your experience?...

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