10.22.18|Posted by Nick Kommatas

How to treat whiplash with physiotherapy

Nick Kommatas is an Ascenti Physiotherapist based in Stoke on Trent.  In his clinic he sees a lot of patients with whiplash who have been referred to us for treatment by a medical agency or solicitor.  Nick explains what whiplash is and the best way to manage your recovery. 

Whiplash can feel very worrying because often the pain is delayed and then develops suddenly.

It can leave you in a lot of pain and unable to complete simple tasks, such as reaching for a cup, driving or moving around normally.

When you search whiplash online you may find a lot of information about the possible injuries or irritation to your body and a whole range of scenarios, including the very serious.

It is important to remember that the majority of whiplash injuries are not serious and that you will make a full recovery with the right management and treatment.

What is ‘whiplash’?

Whiplash is the term commonly used to describe when your body is suddenly thrust forwards and back again. So the same pattern of movement as a whip.

When this motion happens unexpectedly and with considerable force, you don’t have time react and brace yourself properly for the impact.

This can lead to injury of the soft-tissues which is when your muscles, ligaments or tendons become pulled leading to irritation and sensitivity. This typically affects the neck and upper body.

Whiplash has become commonly associated with neck pain following car accidents, but there are many different causes and it can affect anyone.

For example, people who play contact or tackle based sports such as rugby or boxing may also experience whiplash.

What are the symptoms of whiplash?

If you have been in a whiplash related accident then you may initially feel OK.

In response to the shock your body will have produced adrenaline and other hormones to protect the area and delay the onset of pain.

As these wear off when you are relaxed and back home, you will start to feel symptoms and pain, usually in the neck and or shoulder area.

You may also experience headaches or a feeling of pain and numbness that travels down your arms.

When is whiplash serious?

If you experience any dizziness, nausea, problems with your balance or double vision following an accident then you should seek urgent medical attention by calling the NHS helpline on 111 or visiting A&E.

As with any soft-tissue injury there are different levels of severity when it comes to whiplash. 

We use a grading system to diagnose whiplash and will rule out any serious pathology or damage when we first see a patient.

The vast majority of people with whiplash have grade one or two. 

  • Grade one whiplash is when you have some discomfort and pain, but no loss of movement. 
  • Grade two is discomfort and pain alongside mobility issues and restricted movement. 
  • Grade three whiplash is a more serious injury to the soft-tissues, pain, lack of movement and possible neurological effects as well. 
  • Grade four is a serious injury to the neck area with a possible fracture or dislocation. 

But I was given a neck collar at the accident?

Depending on the extent of the injury some people are placed in a hard collar at the time of the accident before they are seen in A&E.

This is just a precaution and not a sign that the doctors believe you have a serious injury.

Often in A&E the collar is removed without having an X-ray so try not to be too worried if you get discharged without an X-ray.

There are other indications of a serious grade four injury which the doctors will have asked you about.

How long does it take to recover from whiplash?

Every individual, accident and whiplash injury is different, so the rehabilitation and treatment plan that your physio prescribes may vary depending on your own personal circumstances.

Recovery timeframes will also vary, but the majority of people will make a full recovery from whiplash within six to eight weeks.

If you are struggling to make a full recovery or seeing little improvement within 12 weeks then you may be referred to a specialist.

What can I do to manage the pain?

You should book an appointment with a physiotherapist as soon as you can so that they can assess your whiplash and provide you with a treatment plan.

Here are five ways that you can manage the pain within the first 72 hours or before you are able to see a physiotherapist:

1. Rest – Avoid any overly strenuous activities, such as going to the gym or heavy lifting. When you lie down make sure that you are supporting your neck and back on the sofa or with pillows.

2. Heat and ice – Many people find that this offers fast relief from the pain of whiplash. 

Some people find ice more effective and others find heat more effective. You should use whatever feels right for you. 

Leave the ice on for 5 minutes during the first three days after injury or heat on the area for up to 15 minutes and repeat roughly every two hours. Wrap the ice or heat in a tea towel to avoid causing any irritation to the skin. 

You can read more about applying ice and heat at home here

3. Keep moving – You should rest the affected area and avoid any activities that may cause further aggravation, but avoid complete ‘bed rest’ and immobilising your whole body. 

Keep moving as much as you are able to within your pain threshold. This will help to keep blood flowing and mobility in your muscles. 

4. Painkillers – You may need to take painkillers with the advice of a pharmacist or doctor.  

5. Relax – Tensing into your pain and holding your posture in a certain way to guard your neck can prevent recovery and start to create bad patterns. 

Whiplash pain relief tips

Try to relax if you can and think about your posture. Taking a warm bath or shower can help, as can this relaxation exercise:

1. Lie comfortably on your back and place a pillow under your knees if you find this makes you more comfortable.
2. Tense each body part for 3-5 seconds by contracting the muscle, then let go all at once and relax.
3. Work through the muscles in your body one at a time, starting with your scalp and moving down to your ears, face muscles and eventually your neck, shoulder and hands. 
4. Try repeating this throughout the body for a few minutes, before relaxing completely.

How can physiotherapy help whiplash?

There are lots of ways that we can work to treat whiplash and help our clients to make a full recovery.

At your first appointment I look at the affected area and ask questions so that I can understand exactly what has happened to the neck.

I will then propose a personalised treatment plan and provide some therapies if I have time, but if not I will deliver the bulk of the treatment at the follow up appointments. 

Hands on treatment or what we call manual therapies are effective in the treatment of whiplash and can offer effective relief from the pain. Examples are:

These therapies help to offload your muscles and to relieve tension, whilst improving mobility in the area and optimising the healing process.

I also prescribe exercises for patients to complete and advice about how to manage whiplash at home. This is also an important part of the recovery process. 

Find out more about our treatments and services or book an appointment now. 

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