The Role of Chiropractic Treatment in Whiplash Injury
Whiplash
or whiplash-associated disorders (WADs) commonly involve the cervical spine.
The natural history of neck pain is poorly understood, and little research
about its causes or treatments has been performed. The severity of symptoms and
the severity of trauma are not always directly related. Few objective findings
are correlated with the symptoms reported in the head, neck, or upper quarter.
The duration of symptoms are signs associated with whiplash are reported by
numerous authors to be between 2 to 6 months. However, the magnitude of this
problem cannot be overestimated. In a survey of more than 10,000 cases of WAD
pain, it persisted in 25% of the cases for 5 years after the accident.
Neck
pain is not only common following an automobile accident but is common
independently of traumatic origin as well. The incidence of neck and shoulder
pain is quite high in the general population. The point prevalence (number of
individuals suffering at a given point in time) of neck and shoulder pain is
between 10% to 22%. The 1-year prevalence is 16% to 40% (number of individuals
who will have discomfort during a 1-year period). The lifetime prevalence falls
between 50% and 70%.
Keys to Recovery: The 5 R’s
1. Reassurance that no serious disease is present and that
improvement is likely to begin rapidly
2. Relief of pain with medication or manipulation
3. Reactivation advice that normal activities can be resumed
(walking, swimming, biking) and education
about simple activity modifications to reduce biomedical strain (ie,
Brugger relief position, chin tucks)
4. Reevaluation of those entering the subacute phase for
structural, functional, or psychosocial factors
5. Rehabilitation/reconditioning/reeducation of muscles with
McKenzie, stabilization, progressive strengthening, or cognitive-behavioral
(indicated if high “yellow flags” score) approaches.
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