Research shows that doctors can and should be doing a better job in the treatment of whiplash injuries. Current trends in the medical treatment of whiplash not only increase long-term morbidity for millions of Americans; the ineffectiveness of care makes it very difficult to quantify correctly the damage done by auto accidents. Patients with acute neck pain develop chronic neck pain in up to 40% of cases (1). When whiplash injuries receive normal care, long-term loss of mobility in the cervical spine can result in vocational limitations and self-imposed lifestyle limitations that last long past the close of personal injury claims. Treating whiplash correctly at the outset not only costs less for the nation and improves patient health; treating whiplash correctly at the outset puts the costs upfront so they can be correctly quantified for personal injury claims.
The problem is that normal medical care for whiplash consists of rest and a soft cervical collar for comfort (2). Research published in Spine, the premier peer review journal for spine related pathologies, shows this approach to be bad for your clients (3-5). One study compared treatment plans for more than 100 whiplash patients. Groups received standard care (advice from a doctor for restricted activity and advice on stretching that was to begin several weeks after the accident), active care within 96 hours of the injury, and active care within 14 days of the injury. Active care consisted of physical therapy evaluation, posture control, and neck rotation exercises. At six month follow-up and at three-year follow-up, the active treatment groups experienced significantly less pain and sick leave. Researchers also compared neck range of motion between treatment groups and a control group that had received no trauma to the neck. At three years, only the group that had received active treatment within 96 hours of the accident enjoyed neck range of motion approaching that of the uninjured group. In terms of pain and range of motion after three years, it was better to receive active treatment within 96 hours of the accident – not rest and restricted activity (4). Researchers also performed an economic study taking into account the cost of physical therapy and the cost of time off work. They demonstrated that active treatment was less costly and more effective (5).
One of the reasons that active treatment very soon after an injury proves more effective has to do with the laying down of new healing tissues. Put in basic terms, as the body lays down new tissues to heal a sprain, it has only one blueprint for the best way to lay those tissues down: movement. Without movement, the new tissue will form in counterproductive patterns. The knowledgeable doctors and therapists at Care Medical Center will introduce thorough but pain-free movement in the injured areas to help the healing response pattern new tissues correctly. For a science-based, effective approach to injury care, please refer your clients to Care Medical Center.
1. Schofferman J, Bogduk N, Slosar P. Chronic whiplash and whiplash associated disorders: an evidence-based approach. J Am Acad Orthop Surg, Vol 15, No 10, October 2007, 596-606.
2. Vega C. Active Intervention Best for Whiplash (CME). Medscape: November 24, 2003. Online resource last accessed 1/12/2009. Available at: www.medscape.com/viewarticle/464912_print.
3. Rosenfeld M, Gunnarsson R, Borenstein P. Early intervention in whiplash-associated disorders. Spine, 2000, 25 (14): 1782-87.
4. Rosenfeld M, Seferiadis A, Carlsson UJ, et al. Active intervention in patients with whiplash associated disorders improves long term prognosis. A randomised controlled clinical trial. Spine 2003, 28, 2491-2498.
5. Rosenfeld M, Seferiadis, Gunnarsson. Active invlovlement and intervention in patients exposed to whiplash trauma in automobile pressures reduces costs. A randomised controlled clinical trial and health economic evaluation. Spine 2006, 31, 1799-1804.
For Your Health,
Dr. Ryan Moorman