What is it?

Whiplash results from the head being suddenly jerked backwards and forwards. It can result in injury to bones or soft tissues in the upper body which are collectively referred to as Whiplash-Associated Disorders.

How does this happen?

Whiplash-Associated Disorders most commonly occur after a road traffic accident where the car you are travelling in is rear-ended. They can also occur from sports, diving and other activities.

What are the symptoms?

Other symptoms which can also occur include:

• Restricted movement of the neck
• Stiffness in the upper body
• Pain around your jaw
• Fatigue
• Tingling, pins and needles or numbness in the arm
• Muscle spasms

 

How is it diagnosed?

Whiplash-Associated Disorders are diagnosed by an assessment from a healthcare provider (e.g. Doctor, Registered Physiotherapist etc). This assessment typically starts with some questions about how this injury occurred, your symptoms and your past medical history. You may be asked to fill out a questionnaire to give your healthcare provider further insight into how this injury is affecting different areas of your life. 

 

A physical exam will then be carried out during which you will be asked to perform simple movements like looking to the left/right. Your healthcare provider will carry out certain tests to check what structures are involved. You may be sent for an x-ray to rule out bony injury. It is rare that a MRI or CT scan will be required. 

 

After all of this your injury will be classified depending on the severity of it and the structures involved. Whiplash-Associated Disorders are graded from 0 - IV, with 0 being the least severe and IV being the most severe. Typically in clinical practice we mostly see grade I - II. 

 

What treatment will I need & how long will it take to recover?

Research shows that the earlier you attend a healthcare provider after your injury and the earlier you start a treatment programme the better your recovery will be.

Initial treatment may involve medication to help reduce pain levels.

Evidence-based guidelines recommend starting gentle movement exercises as soon as possible which will help reduce pain and improve your function.

The video "Neck Pain" in the Masterclass Section will take you through tips and strategies on managing neck discomfort, while keeping yourself moving. The "Neck Stretching" video goes through some gentle movement exercises.

 

 

Treatment for the majority of people will consist of exercise. Studies have shown that Whiplash-Associated Disorders respond best to:

• Movement or mobility exercises for the neck, upper back and shoulders.
• Strengthening of the upper back, mid-back and neck.

The Niggly Neck Rehab Series is a progressive series of classes which includes all of these exercises. It is suitable for Whiplash-Associated Disorders (> 6 months previous).

 

 

The most important piece of advice for a quick recovery is to keep moving!!! Research shows that if we move as normal and go about our daily lives as normal (within pain limits) that it aids a speedy recovery. 

 

Recovery time frames vary as there are many factors involved. Approximately 50% of people recover within one year. For a more severe injury it can take up to three years to see full resolution.

 

TAKE HOME MESSAGE:

Keep moving, stay active and return to work as soon as possible to promote a smooth and swift recovery!

 

Information sourced from:

Pastakia, K., & Kumar, S. (2011). Acute whiplash associated disorders (WAD). Open access emergency medicine : OAEM, 3, 29–32. 

National Institute for Health and Care Excellence (NICE) (2018). Neck Pain - Whiplash Injury.

 

Low back pain is the largest cause of disability worldwide and it makes up most of what I see in clinical practice. So for those of you who suffer from low back pain (if you are reading this I imagine you have experienced it!) know that you are not on your own with it. Low back pain affects up to 84% of people at some point in their lives. Unfortunately for 11% of males and 16% of females low back pain ends up being long-term.

It is important to point out that not all low back pain is the same. The majority of cases (95%) of low back pain have no known cause (what we would call non-specific low back pain). If you have seen healthcare professionals or had different tests done only to be told there’s nothing to be found you are not alone. Scans like x-rays or MRIs are actually only recommended if serious pathology is suspected, which make up 1-4% of cases.

When searching the internet for ways to manage low back pain (hello Dr Google!) it can be challenging to find reliable information. To help with this, there are a few best-practice evidence-based clinical guidelines which I will summarise here, namely:

• The National Institute for Health and Care Excellence (NICE)
• Scottish Intercollegiate Guidelines Network (SIGN). 

The key takeaways from these are:

1. Get exercise

One of the main recommendations In both of these guidelines is that exercise should form the basis of all treatments for low back pain. Further treatment is only recommended in addition to exercise.

2. Get advice

While exercising is important, it is also important that you get advice to make sure that it is the exercise most suited to your needs.

3. Type of Exercise

It has been shown that unloaded exercises like pilates, yoga or tai chi are as helpful as resistance exercises. Interestingly however, walking alone is not an effective form of exercise to manage low back pain. Pilates has been shown to be better than minimal intervention and a number of high-quality clinical trials recommend stabilisation exercises, which are included in pilates, for those with long-term low back pain. 

4. Provision of Exercise Videos

These guidelines also report that the provision of exercises videos improves the performance accuracy of the exercises. 

5. Keep at it!

Exercise performed for more than twelve weeks, in particular, has shown significant reduction in pain intensity and the effect this pain has on the individual’s quality of life. 

So, incase you can’t see the point I have been attempting to make with this blog(!), low back pain is a massive problem globally with a huge impact on the individuals experiencing it. There is strong evidence for the use of exercise in the treatment of low back pain and it is recommended in best-practice clinical guidelines.

The take home message: get exercising!!!

Remember: an assessment by a healthcare professional is always recommended before commencing exercising, particularly if you have medical issues or pain.