Whiplash is the term commonly given to traumatically-induced neck pain, most commonly arising secondary to road traffic collision trauma. The term acceleration-deceleration injury is also used to describe this clinical syndrome. It may involve a range of symptoms, most commonly neck and shoulder pain, upper back pain, upper arm pain and headaches. Multiple tissues can be involved, including joints, ligaments, tendons and nerves. Severe accident related injuries require medical attention.
Evidence based summary for manual therapy [53]
There is reliable evidence that supports the effectiveness of chiropractic for some of the symptoms related with whiplash (such as the soreness and stiffness associated with ‘mechanical neck pain’) but the experts approached by the Advertising Standards Agency (ASA) dispute there is sufficient evidence for chiropractors to claim they can treat whiplash or acute neck related injuries [165-169], see Back-in-Action clinical comment below.
Some researchers claim they have found the highest current standards of scientific evidence suggesting that there is moderate quality of evidence (on a scale of inconclusive, moderate and high) that mobilization combined with exercise is effective for acute whiplash-associated disorders [56]. The recently published best evidence synthesis by the Bone and Joint Decade 2000- 2010 Task Force on Neck Pain and Its Associated Disorders represents the most recent and comprehensive systematic review of the literature for non-invasive interventions, including manual treatment, for neck pain [18]. For (mild) whiplash associated disorders, they concluded that mobilization and exercises appear more beneficial than usual care or physical modalities.
Other effective non-invasive physical treatments or patient education
Back-in-Action Clinical Comment
The question here is about severity and people’s safety. The ASA are rightly tasked to make sure people with traumatic injuries get appropriate medical care as a first priority and are not delayed in this. Severe and moderate traumas most likely need medical attention, investigation, intervention and healing time. Once a severe whiplash has been fully investigated and had time to heal properly, then if there are remaining symptoms of ‘mechanical neck pain’ such as soreness, neck stiffness or tension, then a consultation with a chiropractor may be appropriate.
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