The impact of rehabilitation on chronic whiplash

Abstract

One of the most prevalent causes of neck pain is related to automobile accidents in the form of “Whiplash”, or acceleration/deceleration injuries. The debate on causes of chronicity of symptoms, pain mediation, the most effective treatment regime and the socio-economic impact of the problem has produced a marked increase in the number of research studies and funding available for such in recent years. Whilst the majority of chiropractors include basic ergonomic advice in their treatment of cervical dysfunction, Spinal Manipulative Therapy (SMT) alone is still the treatment of choice. This is despite the lack of conclusive statistical evidence to support this approach. Recent interest and preliminary research in the effectiveness of a combined approach, incorporating rehabilitation of the cervical spine via sensorimotor and cervical stabilisation techniques, has created much interest. The following case demonstrates how the initial SMT approach failed to gain a satisfactory improvement in the clinical symptoms. Emphasis is placed on the ability to perform rehab at home without the need for specific rehabilitation equipment, which is still not widely available in many chiropractic clinics. The Biopsychosocial model and the effect that an active patient approach has on this often-chronic problem is discussed.