Whiplash is often a self-limiting
condition, which means that it will eventually get
better following some basic or minimal treatment.
Short-lived whiplash is sometimes referred to as an
acute whiplash injury. Other
cases of whiplash can cause a wide range of
troublesome symptoms that are often severe and last
for a considerable length of time. Whiplash that
lasts for six months or more is sometimes known as
chronic whiplash or late whiplash syndrome. Treatments for both are outlined
below.Acute whiplash
Research has shown that if you
have severe pain at the time of your injury, and you
later experience a variety of symptoms, your
recovery time is likely to be longer and your
chances of developing chronic whiplash are greater. There is no clear-cut evidence
about the best way to treat an acute whiplash injury
because most of the studies that have been carried
out to date have been of poor quality.
Mobilisation
However, most healthcare
professionals agree that active interventions, such
as neck exercises and keeping the neck mobile, are
better than inactive interventions, such as resting
the neck and keeping it still by using a neck brace
or collar. Even though you may experience a
considerable amount of pain, keeping your neck
mobile from an early stage will help to improve its
functionality and speed up your recovery. Resting your neck and keeping it
still is likely to prolong your symptoms and delay
your recovery. Any pain that you experience when
moving your neck is normal and will not cause
further damage.
Medication
Analgesics (painkillers), such as
paracetamol, can be used to help relieve the pain of
an acute whiplash injury. Paracetamol is usually recommended
as the first painkiller to treat mild to moderate
pain. For neck pain, regular use of paracetamol is
thought to be more effective than only using it when
the pain is at its worst. If your pain is severe,
your GP will be able to prescribe a stronger
painkiller, such as codeine. Codeine can also be
used in combination with paracetamol to provide
increased pain relief. Ibuprofen, a non-steroidal
anti-inflammatory drug (NSAID), can ease pain and
reduce inflammation. Always follow the manufacturer’s
recommended dosage instructions when taking
painkillers and NSAIDs. Do not take ibuprofen if you
have a peptic ulcer (an open sore on the inside
lining of the stomach) or if you have had one in the
past. Also avoid taking it if you have severe heart
failure (where the heart does not pump blood around
your body effectively) or severe liver disease. There are also a number of other
health conditions where ibuprofen should only be
used with caution.
Physiotherapy
If your whiplash symptoms continue
to give you problems for several weeks following
your injury, your GP may recommend trying
physiotherapy. Physiotherapy uses a variety of
physical methods, such as massage and manipulation,
to promote healing and wellbeing. It can often help
to restore a person’s range of movement following an
injury such as whiplash. As well as helping to relieve pain
and stiffness in your neck using massage and
manipulation, your physiotherapist will also be able
to advise you about neck exercises that you can do
at home.
Chronic whiplash
Whiplash that persists for six
months or longer is known as chronic whiplash. As
with acute whiplash, there is little in the way of
concrete evidence to suggest what the best approach
for treating chronic whiplash is, and which
treatments are most effective. However, similarly to acute
whiplash, if you have chronic whiplash it is
recommended that you keep your neck mobile and
continue with your normal daily activities. For chronic whiplash, a treatment
plan should be based on your specific set of
symptoms and should focus on dealing with the cause
of your pain.
Medication
As with acute whiplash, a number
of different painkillers may be recommended to
provide pain relief. The specific type of painkiller
recommended for you will depend on the severity of
your pain and how long it usually lasts.
In some cases, paracetamol or
ibuprofen taken as and when required will often
provide sufficient pain relief. If not, you may need
to take them more regularly.
If your pain is more severe or
prolonged, your GP will be able to prescribe a
stronger painkiller, such as codeine, which can be
used on its own or in combination with paracetamol
or ibuprofen. When using paracetamol or ibuprofen,
always follow the dosage instructions provided by
the manufacturer.
Anxiety and depression
Whiplash that lasts for several
months or longer can sometimes cause anxiety and
depression. If the injury was the result of a motor
vehicle accident, sorting out the damage to your
vehicle and dealing with compensation claims can
often be stressful and time-consuming.
If your symptoms are particularly
painful or chronic (long-lasting), you may begin to
feel depressed. It is important to try to remain
positive and focus on your treatment objectives.
However, if you begin to feel depressed, visit your
GP who will be able to recommend treatment.
Your GP may refer you to a
specialist pain clinic for further assessment and
treatment, or they may recommend that you see a
psychologist for counselling. Alternatively, they
may refer you for a short course of cognitive
behavioural therapy (CBT), where a therapist will
help you to manage your problems by changing how you
think and behave.
Self-care
As well as keeping your neck
mobile and using medication to reduce pain, the
self-care measures listed below may also help you to
manage the pain and stiffness in your neck and
prevent them from getting worse.
- Good posture. You should
maintain a good, upright posture by keeping your
back straight while you are sitting, standing
and walking. If you spend a considerable amount
of time using a computer, you should ensure that
your chair and computer screen are correctly
adjusted.
- Supportive pillow. Some
people find that a firm, supportive pillow helps
when sleeping. You should avoid using more than
one pillow.
- Yoga. Doing controlled
exercises and stretches will help you to improve
your strength and posture. However, there is no
evidence to suggest that they help to reduce
neck pain.