Initial Treatment Approach for Whiplash-Associated Neck Pain

While neck pain is one of the most common reasons patients seek chiropractic care, the underlying cause of neck pain can vary. In some patients, the cause may be unknown or it may be the accumulation of years of poor posture, bad ergonomics, and an unhealthy lifestyle. In other patients, such as those who experienced a whiplash event in a rear-end automobile collision, the cause is well known and better understood. Is neck pain related to whiplash associated disorders (WAD) different than other types of neck pain, and what’s the best initial approach for those with traumatic vs. non-traumatic neck pain?

In a 2020 study, researchers compared the initial presentation of 22 patients with mechanical neck pain (non-traumatic) and 28 patients with grade I or II WAD-related neck pain with or without loss of range of motion but no neurological sensory deficits, motor weakness, and/or decreased or absent deep tendon reflexes.

A review of participant-provided assessment data as well as examination findings revealed the WAD patients exhibited higher neck-related disability, felt pain over a larger area, and had a lower pressure pain threshold over the tibialis anterior (the muscle next to the shin bone).

In the next phase of the study, each patient received two treatments a week for three weeks that included soft tissue techniques targeting trigger points in the cervical region, spinal mobilization, muscle energy techniques, manual traction, and specific cervical spine exercises. This is the type of multimodal approach a patient may receive from their doctor of chiropractic to restore normal motion to the cervical joints as well as to strengthen the deep cervical muscles that often become deconditioned following an injury to the cervical spine and associated tissues.

The researchers hypothesized that due to greater symptom severity and sensitivity to pain, the WAD patients would not respond as well to care. However, patients in both groups reported similar overall improvements in pain and disability following just six treatments.

The findings suggest that a multimodal approach can benefit both types of neck pain patients. However, those with WAD may require more office visits to reach maximum improvement. Treatment guidelines encourage patients to utilize conservative options first, of which chiropractic care is an excellent choice. In the event an individual develops neck pain, either from whiplash or non-traumatic origin, it’s important to seek care sooner rather than later, as delaying care can increase the risk the condition becomes chronic and more difficult to manage.

Author
Dr. James Sheehan Dr. James Sheehan is an expert in the treatment of neck and back pain.

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