A new study suggests that neck pain from whiplash may be relieved just as well by counselling on how to manage the condition as by physical therapy. The counselling was given in addition to a list of optional exercises and compared to an intensive physical therapy programme in the research carried out in Sydney, Australia.
Whiplash is a common cause of ongoing neck pain and disability, with car accidents the leading cause of whiplash, which may also be a result from a fall or other source of trauma to the upper back, neck and/or head. This type of injury causes abrupt flexion and then extension of the cervical spine, resulting in overstretched ligaments, intense pressure on the spinal discs, stretched nerves, and other tissue trauma.
Symptoms of Whiplash
Symptoms of whiplash may include neck pain, persistent headaches, abnormal sensations in the upper limbs, face, neck and chest, and other issues related to nerve damage and possible spinal cord compression. More than half of all those with whiplash continue to have pain up to six months after the initial accident, and 30% have moderate to severe disability from the accident.
Zoe Michaleff, lead author of this new study, and a PhD candidate at The George Institute for Global Health in Sydney, Australia, expressed surprise at the results of her research which involved 150 patients between 18 and 65 who had whiplash-related pain for at least 3 months up to five years. All of the participants reported at least moderate pain or moderate disability caused by the pain. None had received treatment for whiplash.
20 Physical Therapy Sessions vs. 1
The study involved the patients receiving materials to help educate them about coping with whiplash, along with neck exercises and other exercises they could carry out at home if they so wished. Half of the patients then attended a course of 20 one-hour intense exercise sessions with a physical therapist to get one on one treatments for 12 weeks. These exercises were designed to improve flexibility of the neck and spine, as well as to aid posture and balance.
The other half of the patients had a meeting with a physical therapist for one hour in which they could ask questions about the booklet with the advice and exercises. These patients could also contact the PT twice more for additional information.
All of the patients had their pain assessed on a scale of 1-10, with 10 the highest level of pain. Measurements were taken at baseline, at 14 weeks, six months and a year. Patients were also asked to provide their assessment of their progress, including details of their disability and range of motion in the neck.
No Significant Differences in Pain
At the start of the study the PT patients had a mean score of 5.5/10, and the counselling group 4.9/10. By the one year mark these had dropped to 3.7 and 4.4 but the difference was not statistically significant. The same was true of the patients’ own assessments of recovery and their range of motion, with more improvement seen in the physical therapy group but not a significant difference.
Single PT Session Just as Good
These results suggest that for patients unable to commit, due to time or finances, to multiple physical therapy sessions, a single session is just as effective in the longer-term. Of course, each patient is different and it may be that physical therapy would have additional advantages for some people, especially those with existing neck problems or other spinal issues.
Anyone experiencing whiplash should also be sure to adhere to physician advice regarding the use of neck braces and pain medications as inappropriate use of these could hinder recovery and exacerbate neck pain after whiplash. Of course, the best thing to do is to try to avoid serious injury involving whiplash – watch this video on safe posture in the car