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Warning Signs for Chronic Whiplash

Warning Signs for Chronic Whiplash
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Whiplash injury can occur from any rapid acceleration/deceleration of the head and neck, and it can lead to a cluster of symptoms including neck pain, headache, dizziness/balance loss, fatigue, depression, irritability, mental fog, tinnitus, and more that is collected under the umbrella term whiplash associated disorders (WAD). The current data suggest that roughly half of WAD patients will experience chronic symptoms and 15% may report ongoing severe pain–related disability. Are there warning signs that manifest soon after injury that can help identify patients at risk for chronic and persistent WAD symptoms? Let’s find out…

In a November 2022 study, researchers looked at one year of data concerning 740 whiplash patients and found that those who experienced posttraumatic stress symptoms, sensory hypersensitivity, and neck pain-related disability early on were more likely to have chronic WAD at the close of the study. In a separate study, researchers observed that whiplash patients with higher pain intensity and sensory and motor dysfunction early on were more likely to have reduced work capacity a year later. The findings support the concept that WAD is a complex injury with several underlying mechanisms.

What can be done in the early phase of care to reduce the risk for chronicity, especially in WAD patients with one or more of the risk factors described above? First off, and most commonly associated with chiropractic care, is the adoption of a multimodal approach focused on relieving pain and improving function. This may include manual therapies (manipulation, mobilization, massage, or soft-tissue release techniques), physiotherapy modalities (electric stim, ultrasound, laser, or pulsed electromagnetic field), exercise training, dry needling, acupuncture, nutritional counseling, and more.

Another key component is patient education regarding maintaining as active a lifestyle as possible. That is, there’s a balance of activity modification to allow injured tissues the opportunity to heal and staying active to prevent the muscles in the neck and shoulders (especially the deep muscles that are used to stabilize the body and maintain good posture) from becoming deconditioned and atrophied. When these deep muscles weaken, the superficial muscles that are used for movement have to pick up the slack. Over time, the muscles can become overworked, increasing the risk for further injury. Psychosocial factors like depression and anxiety are often present in WAD patients, whether they manifest in response to injury or pre-existed it. If mood disorders or psychological factors may be inhibiting progress, the patient may be referred to a mental health professional to help co-manage their care.

Doctors of chiropractic have several tools at their disposal to help them monitor your pain intensity, disability, and activity tolerance while you’re under their care. This will not only help them document your recovery but also make changes to your treatment plan as needed.


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