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.