What is whiplash?

Figure 1: Neck Pain - Whiplash - Physio Frenchs Forest, Physio Macquarie Park

Whiplash or whiplash associated disorders (WAD) are injuries that happen after an acceleration-deceleration movement, which usually occur following a car accident or blow to the head during sport. Whiplash can affect the muscles, ligaments, joints and nerves in the head and neck area.

 

Figure 2: Neck Pain - Whiplash - Physio Frenchs Forest, Physio Macquarie Park

What are the signs and symptoms of whiplash?

There are a wide variety of symptoms such as pain, stiffness, muscle spasm and headache, in the absence of a lesion or structural pathology. These symptoms do not always present immediately post injury and can show themselves hours or days later. If significant trauma to the head is received, whiplash may be masked by loss of consciousness or concussion symptoms and therefore not present until later. The prognosis of WAS overall is unpredictable and differs from patient to patient. Some remain acute with a full recovery and other progress to chronic pain.


 The WAD scale helps health professionals to categorise whiplash:

0 = No complaint about the neck, no physical signs

I = Complaint of neck pain, stiffness/tenderness only, no physical signs

II = Neck complaint and MSK signs. MSK signs include decreased range and movement and point tenderness

III = Neck complaint and neurological signs (decreased reflexes/weakness/sensory deficit

IV = Neck complain and fracture/dislocation

 

What is the treatment of whiplash?

Upon presentation to a physiotherapist, they will clear any red flags such as fracture, VBI, neurological compromise. Initial treatment will consist of an in-depth assessment of signs and symptoms, some gentle manual therapy and exercises to do at home. It is important to reintroduce range as motion as soon as possible, to avoid any lingering stiffness or loss in mobility.

 

It is very important to start physiotherapy as soon as possible as Whiplash can loiter – in fact, if a patient still has symptoms 3 months after the accident, they are likely to remain symptomatic for at least two years, and possibly for much longer. Only 50% of people with injury from whiplash will have a full recovery, and up to 25% may have mild levels of disability and the rest moderate to severe pain and disability.

 

See our expert Physiotherapy team at Frenchs Forest and Macquarie Park!

References:

  • Bragg KJ, Varacallo M. Cervical (Whiplash) Sprain. InStatPearls [Internet] 2019 Apr 10. StatPearls Publishing.Available from:https://www.ncbi.nlm.nih.gov/books/NBK541016/

  • Ritchie C, Hendrikz J, Kenardy J, Sterling M. Derivation of a clinical prediction rule to identify both chronic moderate/severe disability and full recovery following whiplash injury. PAIN®. 2013 Oct 1;154(10):2198-206. Available from: http://www.udptclinic.com/journalclub/sojc/13-14/November/Ritchie%202013.pdf [Accessed 23 March 2018]

  • McClune T. et al. (2002). Whiplash associated disorders: a review of the literature to guide patient information and advice. Emerg Med J,19, pp 499–506

  • Stace R. and Gwilym S. « Whiplash associated disorder: a review of current pain concepts. » Bone & Joint 360, vol. 4, nr. 1. 2015.

Reece Joneswhiplash, physio for whiplash, frenchs forest, macquarie park, neck pain, physio for neck pain, dizziness, vertigo