Whiplash Injuries
What is whiplash?
It is a collection of symptoms felt in the head, neck, shoulders and sometimes arms, due to the head being unexpectedly forced forwards and/or backwards very quickly often during a car accident. The result is over-stretched and strained muscles, ligaments and joint capsules within the neck. This leads, initially to inflammation in the first 2-3 days, as well as muscle spasm. The more pain, the greater the spasm, the more spasm, the greater the pain!
What to do?
1. Rest
Rest is important in the early stage i.e. either lying down and/or wearing a collar, as this will reduce inflammation and spasm, and prevent aggravating the symptoms.
| Advice: | Wear the collar, or lie down, when you need to reduce the pain, for the first 2-3 days. Then start to wean yourself off the collar gradually - i.e. collar on 1 hour, off 10-15 minutes, on 1 hour, etc. | |
| N.B. | If the collar starts becoming uncomfortable - collar off, If the neck starts to become painful - collar on. |
|
| BUT you should not wear the collar continuously over a long period of time, as this encourages poor posture and weak neck muscles | ||
Do not wear the collar in bed.
2. Pain relief
| a: Ice | Reduces inflammation and swelling, therefore reducing pain and promoting healing. A packet of frozen peas or crushed ice cubes wrapped in a damp tea towel makes a good ice pack. Mould to back of neck, in a lying position. Leave on for 5-10 minutes. |
| b: Warmth | This is also effective for relaxing muscle spasm, but should not be used in the first 2-3 days. Use a hot water bottle wrapped in a towel (to avoid burning skin) for 5- 10 minutes. |
N.B. Any prolonged use of heat or ice can damage the tissues, so don't be tempted to use for longer than stated.
3. Posture
Sitting
Slouching in a chair rounds the back and protrudes the head and neck. This over-stretches the soft tissues, therefore causing more pain and delaying healing. Sit on a relatively high, supporting chair with feet flat on the floor. Place a small cushion or rolled-up towel in the curve of the lower back to maintain an upright posture comfortably. Always make sure your shoulders are relaxed.
Sleeping
Try to keep to a minimum of 1 or 2 pillows. Here are some good ways of getting better support from your pillow.
Tie a scarf around the middle of the pillow to flatten the centre. This will give you more support when you lie on your side. Twist the pillow in the centre for the same effect. Or roll up a towel and slide it into the pillowcase to support the nape of the neck. |
|
|
N.B. Do not sleep on your front.
Daily activities
Avoid sudden movements and modify activities involving flexing the head forwards i.e.:
- 1 Wash hair in the shower instead of the bath or basin.
- Shower instead of bathing as your neck posture in the bath is poor.
- If you have to read or write, prop material up in front of you to avoid craning your neck.
- Avoid stooping if standing i.e. set ironing board higher, put washing-up bowl on top of the draining board.
- Avoid driving as this involves quick head movements and poor posture.
4. Exercises
During the healing process there must be a balance between exercise and rest:
too much movement=aggravation of inflammation
too little movement=the tissues heal in a shortened position, and full movement is lost.
Starting position:
Lying on your back with neck well supported:
- slowly shrug shoulders up to ears and then let go. Feel the new relaxed position of the shoulders.
- stretch arms up above head one at a time to prevent shoulders from becoming stiff.
- gently nod your head.
- slowly turn head to the right, back to the centre and to the left. Aim to get cheek closer to pillow each time.
Progression:
Repeat above exercises in a sitting position with lower back well supported.
You can use your hands to support your head when doing exercise c), gentle nodding in a sitting position.
Repeat exercises 5 times initially and progress to 10 times - approximately 6 times per day
Gradually work on all movements until full range is restored.
Remember you can use ice and/or heat before and/or after exercises for pain relief.
A physiotherapy assessment may be necessary if symptoms persist.
Issued by:..
The Physiotherapy Department, The Ipswich Hospital NHS Trust, Heath Road, lpswich, Suffolk. P4 5PD
Telephone: (01473) 703312 or 703526
Last updated August 1998