For Whiplash, More May Not Be Better
Aggressive treatment can hinder development of coping skills

(HealthDay News) -- Aggressively treating whiplash doesn't seem to speed recovery.

Whiplash -- also called neck sprain or neck strain -- frequently results from a car crash, usually the result of sudden extension and flexion. But whiplash can include injury to spinal joints, discs and ligaments, cervical muscles and nerve roots.

Symptoms -- which can be present immediately after the injury or may not appear for several days -- include neck pain, headaches, dizziness, abnormal sensations and shoulder or back pain, according to the U.S. National Institute of Neurological Disorders and Stroke.

Some people also experience cognitive, somatic or psychological reactions such as memory loss, difficulty concentrating, nervousness/irritability, sleep problems, fatigue and depression. Symptoms sometimes cause significant disability.

Researchers at the University of Toronto studied the treatment given to almost 1,700 people diagnosed with whiplash and found that increasing the intensity of care to more than two visits to a general practitioner, or adding chiropractic care to general practitioner care, was actually associated with slower recovery. The findings, published in Arthritis Care & Research , supported earlier study results by the same team of researchers.

Pressure from people with whiplash often leads doctors to provide treatment, schedule follow-up visits and refer them to specialists when such actions aren't medically necessary, the researchers wrote.

"This in turn may lead to adverse outcomes and even prolong recovery by legitimizing patients' fears and creating unnecessary anxiety," they said.

Early aggressive treatment also can discourage the development of coping techniques, the study found.

"Reliance on frequent clinical care, a form of passive coping strategy, may have a negative effect on recovery by reinforcing the patients' belief that whiplash injuries often lead to disability," the researchers said.

Standard treatment for whiplash, according to the institute, can include pain medications, nonsteroidal anti-inflammatory drugs, antidepressants, muscle relaxants and a cervical collar (usually worn for two to three weeks).

Other treatment options include range-of-motion exercises, physical therapy and cervical traction. Supplemental heat application sometimes helps ease muscle tension in people with whiplash.

Generally, the prognosis for people with whiplash is good, according to the institute. The neck and head pain usually clears within a few days or weeks, and most people recover within three months of their injury. In some people, however, neck pain and headaches linger.

On the Web

To learn more about whiplash, visit the American Academy of Orthopaedic Surgeons.

SOURCES: HealthDay News ; June 2007, Arthritis Care & Research ; U.S. National Institute of Neurological Disorders and Stroke (www.ninds.nih.gov)
Author: Robert Preidt
Publication Date: April 30, 2008
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