During the last several decades, various organizations have published clinical practice guidelines to help steer providers in an evidence-based direction in the management of whiplash associated disorders (WAD). As new evidence is published and confirmed by subsequent studies, guidelines are updated to optimize recovery in a timely and economic manner, as well as reduce the risk of progression to chronic WAD, which can have a dramatic impact on an individual’s ability to work and carry out their daily activities of living. The following recommendations are currently supported in clinical guidelines for managing WAD in a chiropractic context:
- Conservative Multimodal Treatment: Unless a red flag like fracture, structural instability, or severe neurological loss is present, conservative treatment is advised. Studies have identified several therapies that benefit a WAD patient including spinal manipulative therapy, mobilization therapy, soft tissue therapy, massage, physiotherapy modalities, and more. The specific types of treatment used depend on physical examination findings, patient preference, as well as the provider’s clinical experience and training. In most cases, multiple therapies are used in conjunction as such an approach may be most likely to achieve a satisfactory outcome for the patient, often in the shortest time frame.
- Stay Active: In the past, you may recall people who had been in a car accident wearing a soft neck collar, but you seldom see this behavior in the present day. Why is that? It was believed that immobilizing the neck was important to allow the tissues to heal, just like how you immobilize an arm or leg with a broken bone using a hard cast. However, it turns out the practice was more likely to lead to deep neck muscle deconditioning and prolonged the healing process. Nowadays, doctors are advised to encourage their WAD patients to stay active within pain tolerances as much as possible. Patients may receive instruction to perform neck-specific exercises and stretches to facilitate the healing process.
- Patient Education: Most WAD cases stem from automobile collisions, which can be stressful and scary for a patient. The symptoms they’re experiencing may be more severe than any previous injury and it may have had a drastic effect on their daily lives. They may even restrict their activities to avoid worsening their pain or exaggerate their symptoms, both of which can hinder healing and set the stage for chronic WAD. That’s why it’s vital for healthcare providers to assure WAD patients they will get better and to stick to their treatment plan, including carrying on with their lives as much as possible. Referral to a mental health professional may be necessary in some cases.
The good news is that doctors of chiropractic are well-trained in the management of WAD and will co-manage patients with allied healthcare providers if necessary to help their patients to get out of pain and back to their regular lives.
