Stillwaterising's photo

Stillwaterising’s photo

This is a blog post I have wanted to write for while because I am sure you are going to find it very interesting.

Nowadays, a high percentage of my patients are people with whiplash or, as I told you in a previous post, WAD ( whiplash associated disorders) and I thought that this article should be written, as I think that it will help many people. I have realised that the main obstacle in my patients’ recovery is lack of information and, therefore fear.

“What would you do if you have a car accident and your neck and lower back hurt? Wouldn’t you think that rest is the most sensible thing to do?” Many people, who have had an accident, don’t move at all because they think that rest will make their back or neck improve and because movement usually means pain. Well, they are not totally wrong, movement might mean pain, however it also means faster recovery. After reading quite a lot guidelines and treating many patients with whiplash, one thing is clear “movement is the key treatment for whiplash”.

I always like to talk about real cases, so one of them is as follow: male, 25 years old, RTA (road traffic accident), left shoulder pain, X-rays done with no significant findings. The first day he came to my clinic, he had his left arm close to his body and still, in the same way you have it when you wear a shoulder sling. My first question was: ” why don’t you move your arm?” and he responded ” it hurts a lot”. In this situation is when your physiotherapist or doctor should tell you not to worry about the pain and to reassure . I know that it is really easy to talk when I am not the one in pain, but I am going to tell you what the result was and you’ll see that a bit of suffering is worth it in some cases. Well, I saw my patient in a week time and his shoulder mobility was almost perfect and he reported that his pain had reduced in a 60%. Note that I didn’t treat him at all, I just gave him a piece of advice.

Now, I am going to summarize what the ideal treatment for whiplash is, dividing the treatment into three phases: treatment for the acute stage, sub-acute and chronic:

Acute stage (up to 2 weeks after injury)

  • Manual mobilisation: This would be carried by a physiotherapist. It consists in moving different structures to relax tissues and increase the range of motion of your joints.
  • Active exercise: This refers to gentle exercises the patient would need to do. These exercises will help to reduce pain and increase mobility.
  • TENS (Transcutaneous electrical nerve stimulation). Yes, it sounds like a very complex and cool thing, but the reality is that it is basically a device which produces electric current that stimulates the nerves to reduce pain. The benefit of TENS for pain is controversial, though.
TENS by Yeza

TENS by Yeza

Sub-acute stage  (more than 2 weeks and up to 12 weeks after injury)

  • Manipulation and manual mobilisation
  • Exercise therapy
  • Postural training
  • Psychological support
  • TENS
  • Soft tissue techniques, such as massage

Chronic stage (more than 12 weeks after injury)

  • Manipulation and manual mobilisation
  • Exercise therapy

Many professionals would also add acupuncture, heat therapy or/and ultrasound to the treatment, but the reality is that there is not evidence that supports or refuses them.

If you have any questions, do not hesitate to contact me on The Physical TherapyPhysiotherapy Clinic based in Southampton, and I will be happy to help you.

Have a look at the Spanish version, if that makes things easier or want to lear a bi of Spanish Tratamiento clave del whiplash.

Photos note: Photo remix Copyright © 2010 Stillwaterising, available under cc by-sa 3.0 license and Copyright 2008 Simon James, available under cc by-sa 2.0 license. Second photo: Copyright © 2008 Yeza, available under cc by-sa 3.0 license.

 

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