When one hears the word “Whiplash,” it’s possible that the first image that comes to mind is the academy award winning movie starring J.K. Simmons as a controversial music instructor. It’s far more likely however, that one’s primary thoughts immediately turn to the association this word has with neck pain, trauma and more specifically, a motor vehicle accident (MVA). Given the tumultuous, unrelenting “lessons” inflicted on his jazz students throughout the film, a case could be made that it accurately describes both the mental abuse suffered by the aspiring students, as well as the pain associated with this disorder.
According to the Quebec Task Force Review, whiplash is defined as “an acceleration-deceleration mechanism of energy transferred to the neck.”1 But this simplistic definition does not do justice when describing the unpleasant sensory and emotional experience this diagnosis can provoke. Whiplash-associated disorder (WAD) is most specifically related to trauma associated with a car accident – it occurs when the head neck complex undergoes significant amount of displacement without being exposed to direct impact.1 This forward thrust of the head and neck can aggravate the muscles, tendons and joints that support the neck, and can result in significant pain.
While whiplash is most commonly associated with a MVA, it can also occur due to sport-related injuries (football, soccer) and falls that cause an unexpected jolt to the head. Literature has found that post-concussion syndrome can co-exist with WAD, so it’s essential that patients are screened appropriately by their health care providers.2 Current clinical guidelines for the management of acute WAD recommend that radiological imaging (x-ray/MRI) be undertaken only to detect fracture or instability, typically associated with trauma (motor accident).3 Unless deemed necessary by your health care provider, advanced imaging may not be indicated.
The initial cardinal symptoms of WAD include, but are not limited to, pain, headache, dizziness, visual and auditory disturbances, temporomandibular joint dysfunction, light sensitivity, fatigue, arm pain, as well as cognitive difficulties such as concentration and memory loss, anxiety, insomnia and depression.4 More importantly though, it can make even the most basic daily tasks difficult, resulting in increased stress and anxiety, and ultimately contributing to a decreased overall quality of life. 5 Those who experience these symptoms should talk to their physical therapist.
Most of the time, symptoms associated with WAD resolve within 2-3 months following the injury. However, in approximately 50 percent of individuals, pain and dysfunction associated with the injury persist and can cause increased burden on patients, the healthcare system and insurance organizations.6 According to literature, a variety of additional symptoms can ensue if WAD is left untreated, subsequently becoming a chronic problem. 7 8 9 10 11 That’s why it’s so important that acute WAD symptoms are caught early and treated effectively. Early identification of your understanding of pain, expectations of recovery, symptoms and therapy will help with the recovery process. Additionally, understanding what triggers your pain and developing appropriate strategies to minimize those triggers is especially important.
Treatment for WAD consists of a myriad of options, including aerobic exercise, manual therapy, strengthening and stretching. It’s essential that your therapist implement a multimodal approach- one that addresses your symptoms with a focus on resolving your pain and specific limitations.
At Athletico, our therapists understand that no two patients are alike and that every treatment plan will differ accordingly. Our team is trained to recognize the largely variable symptoms of WAD and to treat you effectively and efficiently so your acute injury does not turn into chronic pain. If you or someone you know is suffering from WAD, contact your local Athletico today!
Physical therapy is usually the thing you are told to do after medication, x-rays or surgery. The best way to fix your pain is to start where you normally finish – with physical therapy at Athletico.
The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.
1. Pastakia K, Kumar S. Acute whiplash associated disorders (WAD). Open Access Emerg Med. 2011;3:29–32. Published 2011 Apr 27. doi:10.2147/OAEM.S17853
2. Rebbeck T, Evans K, Elliott JM. J Orthop Sports Phys Ther 2019;49(11):819-828. doi:10.2519/jospt.2019.8946.
3. Saragiotto BT, Maher CG, Lin CWC, Verhagen AP, Goergen S, Michaleff ZA. Canadeian C-spine rule and the National Emergency X-radiogrphy Utilization Study (NEXUS) for detecting clinically important cervical spine injury following blunt trauma. Cochrane Database of Systemic Reviews 2018, Issue 4. Art. No.
4. Elliot JM, Noteboom JT, Flynn T, Sterling M. Characterization of actue and chronic Whiplash-Associated Disorders. JOSPT. 2009.
5. Sterling M, Jull G, Kenardy J. Physical and psychological factors maintain long-term predictive capacity post-whiplash injury. Pain. 2006;122:102-108. http://dx.doi.org/10.1016/j. pain.2006.01.014
6. Sarrami P., Armstrong E. Naylor J.M., Harris I.A. Factors predicting outcome in whiplash injury: a systematic meta-review of prognostic factors. J Orthopaed Traumatol (2017) 18:9–16
7. Sterling M, Jull G, Vicenzino B, Kenardy J, Darnell R. Development of motor system dysfunction following whiplash injury. Pain. 2003;103:65-73.
8. Treleaven J, Jull G, Sterling M. Dizziness and un- steadiness following whiplash injury: character- istic features and relationship with cervical joint position error. J Rehabil Med. 2003;35:36-43
9. Treleaven J, Jull G, Lowchoy N. Standing balance in persistent whiplash: a comparison between subjects with and without dizziness. J Rehabil Med. 2005;37:224-229. http://dx.doi. org/10.1080/16501970510027989
10. Kasch H, Qerama E, Bach FW, Jensen TS. Reduced cold pressor pain tolerance in non-re- covered whiplash patients: a 1-year prospective study. Eur J Pain. 2005;9:561-569. http://dx.doi. org/10.1016/j.ejpain.2004.11.011
11. Wenzel HG, Haug TT, Mykletun A, Dahl AA. A population study of anxiety and depression among persons who report whiplash traumas. J Psychosom Res. 2002;53:831-835.
12. Ritchie et al. Living with ongoing whiplash associated disorders: a qualitative study of individual perceptions and experiences. BMC Musculoskeletal Disorders (2017) 18:531 DOI 10.1186/s12891-017-1882-9