Whiplash: Reviews

 

Cote P, Soklaridis S., Does early management of whiplash-associated disorders assist or impede recovery?, Spine, 36:S275-S279, 2012

Randomised controlled trials suggest that education, exercise and mobilisation are effective modalities to treat whiplash, but epidemiological studies suggest that too much rehabilitation early on can be associated with delayed recovery and the development of chronic pain and disability.

 

Scholten-Peeters GG, Bekkering GE, Verhagen AP, van Der Windt DA, Lanser K, Hendriks EJ, Oostendorp RA., Clinical practice guideline for the physiotherapy of patients with whiplash-associated disorders., Spine, Feb 15;27(4):412-22, 2001

Active interventions, such as exercise, educational advice and normal activity are recommended.

 

Sterling M, Physiotherapy management of whiplash-associated disorders (WAD)., J Physio, 60:5-12, 2014

General narrative review of WAD natural history, prognostic factors, and management, suggesting that after 2-3 months there is no further improvement, with initial high pain and disability, post-traumatic stress, negative expectations, and high catastrophizing associated with poor outcomes. The mainstay for acute WAD is exercise, including McKenzie, although the effect size is small and no particular approach is best, and the proportion that develops chronic symptoms is high. For chronic WAD exercise is also useful. Accompanying manual therapy may enhance outcomes, which should be measured using established pain and disability outcomes.