Whiplash: Advances in
Diagnosis and
Rehabilition

By Sean GT Gibbons BSc(Hons) P.T., MSc Ergonomics, MCPA

Introduction Whiplash injuries occur due to acceleration – deceleration energy transfer to the neck, usually resulting from a car accident. The accident may precipitate a number of clinical symptoms with the most common being neck pain, but headache, arm pain, pins and needles or numbness, dizziness and problems with memory or concentration are also frequently reported. Most individuals recover within a few weeks of whiplash injury from a car accident but a significant proportion (14-42%) develop persistent pain with 10% reporting constant severe pain. Whiplash represents a diverse condition with some individuals displaying a more complex clinical presentation. These characteristics are listed in table 1. These changes can differentiate people with chronic whiplash from people with milder injuries and highlight that a more serious injury has occurred. When these findings are present, specific interventions are required to help as traditional rehabilitation is less likely to succeed. Car accident models show that all structures in the neck have the potential to become injured. Unfortunately, the identification of structural damage has proved difficult probably due to the insensitivity of current radiological diagnostic imaging. Similarly, standard neurological examinations are often normal. Finding a ‘structure’ that is damaged is likely important, however they provide little basis for rehabilitation. It can be argued that it may be more important to place emphasis on treatment approaches directed towards mechanisms and processes underlying the painful condition. Treatment Rehabilitation revolves around specific exercises that enable the brain to either relearn specific sensory tasks or compensate for the injury. Some examples include: repositioning the neck back to a set position, telling the difference between aspects of touch, relearning movement patterns, and retraining balance. Some of these things are done to some extent during some aspects of yoga or tai chi, wii fit, and everyday activities such as walking. Conclusion The ability to know who will develop chronic symptoms following a whiplash injury is important so that appropriate treatment can be given early. New research over the last few years has provided new evidence based interventions for the treatment of whiplash injuries.

A full reference list is available from Sean Gibbons at stabilityphysio@gmail.com Sean is a physiotherapist at Stability Physiotherapy The Family Wellness Place 48 Commonwealth Ave. Mount Pearl, NL He can be reached by calling 709-747-7463 or by email.

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