Physiotherapy treatment of whiplash injuries – OMPTG member Written by Helen David

Physiotherapy treatment of whiplash injuries
Written by Helen David – OMPTG member
What is a whiplash injury?
“Whiplash” is a term that is used to describe the injury that occurs when rapid acceleration - deceleration
forces are applied to the head and neck area. Whiplash injuries are commonly associated with motor
vehicle accidents but can also occur in occupational and sporting incidents.
The impact of the accident may result in soft tissue and bony trauma to the neck, which may in turn cause
a variety of symptoms. The extent of the trauma is dependent on the mechanism of the injury and on the
severity of forces applied to the head and neck area. In the case of a mild whiplash injury, the person
may just experience a sensation of stiffness in their neck for a few hours or days. With more severe
whiplash injuries the person may experience other symptoms such as neck pain, limited neck
movements, headaches, nausea, dizziness and paraesthesia (a sensation of “pins and needles” or
numbness) in their upper limbs.
How should whiplash be treated?
It is advisable for a person who has sustained more severe whiplash trauma to be examined by their
general practitioner or medical staff at a hospital casualty department. X-rays should be taken of their
neck to determine whether they have sustained any ligament or bone injury.
They should be handled with care if they present with any of the following symptoms:
severe neck and/or arm pain
difficulty breathing and/or swallowing
paraesthesia of the arms or of the arms and legs
difficulty supporting the weight of the head
If the traumatic incident is severe, or if any of the above symptoms are present, the patient’s neck should
be immobilised with a hard collar and they must be transported immediately to a hospital casualty
department. The person may need to be examined by a medical specialist such as a traumatologist or a
neurosurgeon. The specialist will decide whether the person’s neck injury requires further medical
investigations or treatment (medication, hospitalisation or surgery). Only a small percentage of people
suffering a whiplash injury require surgery.
Fortunately the majority of whiplash injuries are mild to moderate in severity and the person will recover,
given time and appropriate management. Optimal healing will occur with early intervention. One should
be aware that physiotherapy is a broad discipline and there are many fields of expertise. Members of the
OMPTG (Orthopaedic Manipulative Physiotherapy Group) are physiotherapists who have a special
interest in orthopaedic conditions and are well qualified to provide whiplash injury patients with effective
How can physiotherapy help?
Depending on the severity of the injury, recovery time can vary greatly from a few weeks to as much as
two years. The physiotherapist plays a vital role in educating a whiplash injury victim. The person will be
able to facilitate their own progress if they understand the pathology of their injury and the aims of
treatment. It is important that the person receives support and reassurance because they may initially be
in shock after the accident and later experience anxiety regarding their symptoms. Some may develop
emotional side-effects such as depression, anger and irritability if their recovery time is lengthy. This is
especially common in individuals where the accident was not their fault. In some instances trauma
counseling may be necessary.
During the acute / early phase of a whiplash injury a person may have severe muscle spasm in their neck
region. Physiotherapists are skilled in using various techniques to reduce pain and muscle spasm, thus
allowing healing to occur more rapidly. Studies have shown that effective pain management in the first
three weeks after a whiplash injury is important in order to achieve a good outcome. Wearing a soft collar
may be useful during this phase to provide support to the neck.
It is important to maintain a balance between rest and gentle mobilization / movement. In severe cases it
may be advisable for the person to take sick leave and decrease activities of daily living until their
symptoms have noticeably subsided. In milder cases the person might need to modify their work and
other activities for a period of time. The physiotherapist will suggest a programme of gentle mobilising
exercises which are important to improve the range of movement of the neck and facilitate the
development of ideal scar tissue. Poor postural habits may cause an additional strain to the damaged
structures and advice will be given on improving posture at work and at home.
The physiotherapist will guide the person as to when it is safe to return to work and recreational activities.
Certain activities such as contact sports and heavy weight lifting may need to be avoided for a number of
months depending on the severity of the whiplash injury.
The physiotherapist will progress the individual’s exercise programme. Some exercises are designed to
mobilise the different tissue systems of the neck such as the muscles, joints, neural tissue and connective
tissue. Other exercises are designed to improve the strength and endurance of the postural / supportive
muscles of the neck and shoulder area. Good mobility and muscle function are vital to prevent or
minimize recurrences of neck pain.
It is important to remember that the severity of whiplash injuries sustained in motor vehicle accidents can
be dramatically reduced if seat belts are worn by all occupants at all times and head restraints are
correctly positioned.
How do I find an OMPTG physiotherapist in my area?
Visit our OMPTG website at or email us at [email protected]