Category Archives: APM Broadcasts

Whiplash Explained

This post was written in conjunction with The Academy of Physical Medicine, based on a broadcast with specialist physiotherapist Chris Worsfold

Mechanism of Whiplash

Whiplash is a leading cause of insurance claims, and has recently been put under review by the Ministry of Justice. The MoJ categorises whiplash as a soft tissue injury of the neck- covering muscle and ligament injury. Road traffic accidents can also cause shoulder and back pain, but only neck injuries can be described as whiplash.

Roughly 20% of cases become chronic (lasting over three months). For many cases, this may be preventable. Early intervention to reduce levels of pain have been shown to break the cycle of anxiety, over protection, and increased pain; reducing the time taken to get better. Pain relief may take the form of painkillers, nerve blocks, and manual therapy. Education is important to help reduce fear of movement or further damage, thus reducing pain further.

Chronic pain after whiplash is associated with reduced neck movement in the long term. Movement can be limited by stiff joints, and strained, spasming, or tight muscles. These are symptoms that osteopaths see every day, and can help with in both the treatment room, and at home in the form of tailored exercises. Exercises and/or treatment as provided by an osteopath are recommended for all stages of whiplash in both early and late stages.

Headrest Positioning Guidelines
Image from RCAR, 2008

Above is a diagram to show ideal head restraint placement. During a crash, your head moves up relative to the seat, so the restraint needs to be higher than expected. Correct placement stops your head from being thrown back into extension, minimising strain to the soft tissues at the front of the neck. A low head rest will act as a pivot, further exaggerating extension movement.

Research has shown that osteopathic manual therapy may be beneficial for people with whiplash and chronic neck pain. Your osteopath can also help you understand the details of your whiplash, and devise a plan to help you return to your normal level of activity.

Although only the neck can have a diagnosis of whiplash, it is recognised that other areas can be injured by a collision. Leg pain from the impact of knees on the dashboard; or chest pain from the pull of the seat belt should also be investigated, and may also be something your osteopath can help with.