Treating Whiplash Injuries is a Team Effort
At our chiropractic clinic, we routinely see individuals who have been involved in motor vehicle accidents and suffered whiplash injuries as a result. Any crash serious enough to cause whiplash is likely associated with significant trauma. When developing a treatment plan, it’s important to consider both the physical and emotional components, which are specific to each patient, and which are best addressed by integrative approaches.
Research studies report a high prevalence of anxiety, depression and post-traumatic stress symptoms along with physical symptoms including headache, arm pain, dizziness and sensory disturbances (Sterling, 2018). It is important to consider how each of these conditions contributes to the big picture, in order to prevent the acute injury from transforming into chronic whiplash, which may cause long-term disability driven by pain and anxiety. Typically, this acute period is defined as 2-3 months post injury, but it can take longer. Naturopathic physician, Dr. Don Selvey, emphasizes the importance of staying in front of the pain during this time window, to avoid chronification (private conversation, 2023). As with other chronic pain syndromes, whiplash victims may develop widespread hypersensitivity to pain (hyperalgesia), and consequently fear of movement (Sterling, 2018).
Abnormal posture and muscle guarding can also exacerbate whiplash injuries. Such problems may respond well to physical therapy with cold laser and interferential stimulation, along with chiropractic manipulation (Dr. Carson Robertson, private conversation, 2023). Corrective exercise is also important. Establishing rapport with the patient is key to recovery, so the patient maintains trust in the process, and is willing to complete home exercises.
Dealing with the emotional component of whiplash can be tricky. In many cases, patients respond well to relaxation strategies such as deep breathing, progressive muscle relaxation and guided imagery. Cognitive behavioral therapy can integrate well into primary care and complimentary alternative medical practices, with brief interventions targeting maladaptive thinking and cognitive restructuring.
However, it is important for practitioners to recognize their limits. Patients suffering from severe trauma may require referral to a specialist, particularly if the patient requires psychoactive medications. In this case, it is important for the referring physician to explain reasons for referral to the patient, to avoid the patient feeling stigmatized, or fearing abandonment by the referring physician (Flor & Turk, 2011). Maintaining contact with the patient throughout recovery reinforces the compassion that is essential to the healing process. Continuity of care is at the heart of what being a medical home is all about.