What Are the Best Treatments for Whiplash?

When it comes to whiplash, there are multiple treatment options available depending on where the injury occurred and the resultant symptoms. With some perseverance, dedication, and a positive attitude, treatment results will be optimized.

It is very common that whiplash victims don’t experience the pain right away. It may take a few days to a few weeks for the discomfort to show itself. This can be from adrenaline causing you to not feel any pain.

If you were transferred to the emergency room after the accident, the workup will be to rule out something very acutely serious, such as a fracture or neurologic injury. Once those are ruled out, then the typical diagnosis comes down to a Cervical Strain/Sprain. This can mean a bunch of different things.

Acutely, treatment should consist of some common things such as:

1) Ice, not heat – the objective is to decrease inflammation, and ice may constrict blood vessels and limit the swelling and inflammation. Hence pain may be decreased as well.

Pain medication – Can be very effective in the acute setting for pain relief. It is not recommended for chronic intake.

Muscle relaxers – these medications include Valium, Skelaxin, Soma, Flexeril, etc and act to counter muscle spasm.

NSAID’s – anti-inflammatory medications like ibuprofen and naproxen may help with whiplash pain.

Additional medications that may be considered include neuropathic medications like Lyrica or Neurontin, sleep aids like Ambien or Restoril, and anti-depressant medications such as Paxil or Prozac.

Sixty percent of chronic whiplash pain has been shown to be coming from the facet joint capsule. Pain Doctors have had good results utilizing cervial epidural steroid injections (ESI), trigger point injections, and radifrequency ablation (RFA). RFA gives much longer pain relief typically than an ESI. The medial branches, which are the tiny nerve endings supplying the joint capsule with sensation (and pain) usually regenerate between 270-400 days, so patients may achieve over one year of pain relief.

Whiplash injuries respond typically best to an active and comprehensive therapeutic intervention. The “wait and see” approach may end up in a missed window of opportunity for making great strides in pain relief. Half of whiplash patients end up with chronic pain and 10% of whiplash patients become disabled. That adds up to over 250,000 new disabilities each year in the US.

Physical therapy may be dramatically beneficial to whiplash patients. Ice, heat, traction, ultrasound, deep tissue massage, active and passive range of motion may allow patients to quickly become more mobile and active.

Chiropractors are the single largest group of practitioners treating whiplash injuries. Chiropractors treat 36% of all whiplash victims. The remaining 64% are treated by a combination of generalists (internists, family practice) and acupuncturists. A study in the UK looking at chiropractic treatment for whiplash injuries displayed over 90% effectiveness for relieving whiplash pain.

Other studies have looked specifically at cervical spinal manipulation for whiplash and found the treatment to be very effective.

Evidence on treatment for Mechanical Neck Disorders, of which Whiplash is classified, includes:

Strong evidence = Stretching/Strengthening along with Spinal manipulation

Moderate Evidence = Stretching/Strengthening, IV steroids for whiplash, and epidural injections. Low level laser therapy, electrotherapy (TENS), Intermittent traction (like spinal decompression), and acupuncture.

Limited Evidence = Magnetic stimulation, Chinese massage, trigger point injections, and orthopaedic pillow.