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How to treat a whiplash injury?

© Ozana Pope-Gajic

On the example of the whiplash injury treatment we'll discover what physical therapist can do for a patient with neck problems.

Whiplash, a soft tissue injury to the neck, is common condition, often occur after the automobile accident but it can also occur during a fall or any sudden hit to the head or neck area. Usually, the reason for the neck damage is sudden extension and flexion. When a head and neck move suddenly backward and forward, a protective reflex, called the "stretch reflex" will compress the neck muscles. This situation prevents extreme motion, which might otherwise fracture neck and damage spinal cord. Recently it is known that even a low accident can cause whiplash and person who experience this injury may have problems immediately and even a many years after. Helping your patient to get proper care for whiplash now, can keep him away from serious problems later. This is the reason why should we better analyze this condition.

A collection of whiplash symptoms ranges from neck stiffness, myofascial injuries (injuries to the muscles and ligaments), headache, dizziness, paresthesias (abnormal sensations such as burning or prickling), shoulder or back pain. It's good to know that pain often results from muscle-spasm, which can be treated very effective in a short time. Off course, if we use right methods. You can advice your patient about primary treatment for whiplash injury with low pain intensity. Start with rest explanation. Resting may not be the part of healing process; on the contrary medical practitioners believe faster healing of whiplash is achieved by prolongation with every day activities. But there is some appropriate activity limitations in this every day activities, like for example, lifting, overhead work and etc. Soft cervical collar is recommended if it's a case of severe whiplash and only for a 1-5 days. The basic education should include some self-techniques: ice, heat, medicines and pillows. Instruct the patient about the way of using ice packs (every 20 minutes for a two or three days), then heat (either the shower or heating pad), compose it with over the counter anti-inflammatory drugs and suggest an orthopedic pillow for keeping the proper position of spine's curves. Low training program should include gentle, pain-free range of motion (ROM) exercises. This is the "first aid" for injured neck.

After the 3-5 days, if the symptoms maintains, excessive treatment program is necessary. In this phase of treatment a physical therapist will develop an individual treatment plan, which may contain some passive modalities (like ultrasound, electrical stimulation, massage), plan for cervical traction, exercise strategy for flexibility and strength of neck musculature with gradually increasing intensity.

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