Whiplash Associated Disorders
Whiplash associated disorder describes the injuries sustained to the neck from a hyperflexion/hyperextension injury caused by a collision in a road traffic accident. Primarily the injuries are to the cervical (neck) ligaments and muscles, but can also involve strain of the joints between the cervical vertebrae and/or lesions of the cervical discs. It is common for a patient to report feeling relatively asymptomatic in the immediate aftermath of an accident but for symptoms to occur some time late. Symptoms usually include pain and stiffness, often severe, often radiating up into the head, or downwards across the shoulders and into the arms. Headaches and muscle spasms are common. Rib and sternal pain is also a common feature secondary to the restraining forces applied by the seat-belt. Neurological symptoms such as altered sensation, numbness and weakness are not common but are tested for on examination.
Unfortunately with these injuries, it is usual that complete resolution of symptoms is unlikely for a considerable length of time. However, it is widely accepted that early mobilisation encourages a more rapid recovery and may avoid the development of chronic problems. In the acute stages, the emphasis is on the recovery of good active movements of the neck and upper back in all directions. Manual therapy in the early intervention stage consists of gentle joint mobilisations to regain movement, the application of heat, massage and soft tissue techniques including trigger point release and the instruction of a home exercise programme that is aimed at maintaining good joint movement and soft tissue flexibility. When good active movement is returning and pain is more controlled, improving the strength and stability of the cervical musculature and developing good postural awareness become the main focus of treatment.
In addition to the effective treatment and management of these injuries, the physiotherapists at our clinic are frequently requested to provide comprehensive and detailed medico legal reports and expert witness evidence to the Courts on behalf of our patients.