The unexpected way you can help your patients with whiplash

While many of your patients will see you for ongoing issues, such as chronic pain, there will be a certain percentage of your patients who come to see you for acute problems.

Unlike patients with whom you have an established relationship, these acute care patients come to see you for a specific issue and may, or may not, be back to see you again once this issue has been addressed. Whiplash is one of the most common reason patients may come to see you for acute care.

Whiplash occurs when the head and neck are forcefully and repetitively thrown forward and backward, usually as the result of a car accident. However, it can also happen as the result of a sports injury, physical abuse, or other trauma to the back of the head or neck.

As you know, standard care for whiplash usually involves bracing and adjustments. Some interesting recent research has grouped together findings from several smaller studies to show that neck exercises may also help in cases of whiplash.

Statistics on whiplash

According to the Insurance Institute for Highway Safety, whiplash is the number one reported injury in auto accident insurance claims in the US.¹ As many as two-thirds of all claims filed under bodily injury liability insurance were for neck injury.

Furthermore, one report found that more than 800,000 whiplash injuries were claimed as a result of auto injuries over a 12-year period. Almost a third were the result of a rear-end collision.¹

Symptoms of whiplash

The most common symptoms of whiplash are neck pain and stiffness, loss of range of motion, and headaches that start at the base of the skull.² Depending upon the severity of the crash, and thus how sharply the head was shook back and forth, patients may also complain of dizziness, blurry vision, or tinnitus (ringing in the ears).

Most patients will report improvement within four weeks, although it may take some longer to feel better. However, they may not realize they have an injury right away, as symptoms may not appear until at least 24 hours after the accident.²

Can exercise help for whiplash?

A 2016 article in the journal Manual Therapy conducted what is known as a meta-analysis to examine the strength of evidence among 27 smaller studies for using exercise in treating patients with neck pain, including whiplash.³ A meta-analysis groups together findings from small studies on a similar topic to look for patterns in the conclusions in the hopes of being able to find commonalities that can strengthen the findings.

In looking at the pooled results, strengthening exercises of the upper extremities, neck, and shoulder blades were found to produce moderate to large reductions in pain, both immediately and at short-term follow up for chronic neck pain.³

Cervical, shoulder, and scapula strengthening and stretching exercises showed small to large pain reductions over the long term, as well as functional improvements. Exercises to strengthen and stabilize the neck and scapula improved pain and function over the intermediate term.³

The researchers concluded that strengthening exercises of the neck, scapula, and shoulder for certain types of neck pain are beneficial and merit further study.

Certainly, there are tried and true treatments that work for reducing symptoms of whiplash. However, this meta-analysis may give you another effective treatment tool, with the added bonus that your patients can do the exercises at home.

References

1. Neck injury. Insurance Institute for Highway Safety. http://www.iihs.org/iihs/topics/t/neck-injury/qanda Published April 2018. Accessed Aug. 18, 2018.
2. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/whiplash/symptoms-causes/syc-20378921 Accessed Aug. 18, 2018.
3. Gross AR, Paquin JP, Dupont G, et al. Exercises for mechanical neck disorders: A Cochrane Review Man Ther. 2016 Aug;24:25-45.