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Whiplash Associated Disorders

Whiplash is a common term often related to motor vehicle accidents. But what exactly is whiplash? What is the best treatment and what does it mean for the longevity of your neck health? Read below!

Whiplash is a common term often related to motor vehicle accidents. But what exactly is whiplash? What is the best treatment and what does it mean for the longevity of your neck health? Read below!

What is whiplash?

Whiplash is otherwise known as an ‘acceleration/deceleration’ injury, where the head moves forwards and backwards at high speed resulting in a stretch to the structures in the neck. A very high velocity or complex accident can cause significant injury to these structures, however the majority of motor vehicle accidents DO NOT result in structural damage to the bones, nerves, joints or muscles of the neck. 

 

Pain is often described as an ache in the neck, sometimes extending into the shoulders and arm, or up towards the head. Headaches and/or pins and needles may also present. 

 

I have been in an accident, what should I do? 

Stay calm – remember majority of car accidents do not result in significant damage to your neck. If you have been involved in an accident, it is best to book in with your GP as soon as possible. They will be able to rule out any serious injury, provide pain relief and refer you to begin rehabilitation. Once serious injury is ruled out, the best thing to do is keep your neck gently moving. Heat or ice packs may help to relieve pain and relax muscles.

 

What is the best treatment?

Hands on therapy is rarely used to treat neck pain after a motor vehicle accident. Research shows massage and manipulation do not show lasting benefit and in some cases can be quite uncomfortable. Exercise rehabilitation is the best treatment for neck pain following motor vehicle accidents, which may be a combination of stretching, range of motion, breathing and relaxation exercises and strengthening exercises. These exercises may be performed at home, in the gym or even in the pool depending on your ability. Your physiotherapist can guide you through a progressive rehabilitation program to get you back to your old self. 

 

Will I always have neck pain? 

Absolutely not! Once serious structural injury is ruled out, there is no reason why you can’t have a full recovery. Despite this, it is not uncommon for pain to last a long time after the incident, however the biggest predictors of poor prognosis and ongoing pain are catastrophising and lack of sleep. The type and speed of collision have very little effect on recovery time.

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A Pain in the Neck: How does posture influence neck pain?

Neck or cervical pain is becoming increasingly common, with the highest prevalence among office and computer based workers. Physios commonly hear clients admitting to ‘bad posture’ – but do we really know what bad posture is?

Neck or cervical pain is becoming increasingly common, with the highest prevalence among office and computer based workers. Physios commonly hear clients admitting to ‘bad posture’ – but do we really know what bad posture is?  

There can be many causes to neck or cervical pain, from a joint sprain, disc or nerve injury. This blog will focus on postural neck pain arising from a condition called myalgia, meaning tight, fatigued, painful muscles. This generally occurs without a history of trauma and yet is one of the most common causes of neck pain.

 

It is a common misconception that ‘sitting straight’ will solve all postural pain. 

The neck is designed to move and although you may not realise, sitting in one position for an eight hour shift is quite a work out for your postural muscles. 

 

Posture can have an influence on neck pain: rounded shoulders can create a forward head or chin poke posture, resulting in the muscles at the back of your neck working overtime to hold your head up. What some may not know is sitting very tall off the back of your chair can have an equally bad effect. An overly upright posture places a huge demand on the postural muscles, having a similar effect to clenching your fist for a long time – the muscles get tired and sore!

Although we aim for a ‘neutral’ posture, every body and spine is different and this ‘ideal’ posture looks different for everyone. The most important factor is finding a comfortable position, often with some low and mid back support. Having support over these areas helps ‘unclench the fist’ by offloading the postural muscles. It is important to remember that if you must be sedentary for a long period, you take breaks or change your sitting posture regularly. Neck stretches or rotations, walking to a collegue’s desk rather than emailing them or using a sit-stand desk are all ways to take a break from one sustained posture. 

 

Studies have shown individuals with chronic neck pain (neck pain for 3 months or longer) show reduced endurance of deep stabalising muscles in the neck and have a reduced ability to maintain an upright posture. Although physiothearpists can provide hands on treatment to relieve symptoms, often the underlying cause of pain is a lack of strength and endurance of the muscles supporting the head. Manual therapy should always be paired with postural control and upper limb strengthening exercises. 

 

Take home points: 

  1. Every spine is different, and there is not one ideal posture for everyone 

  2. Sitting in ANY posture for a prolonged time can cause pain, plus being sedentary isn’t good for our physical health

  3. Finding a comfortable, supportive posture at work will reduce the risk of developing postural neck pain

  4. General exercise and specific strength training for the postural muscles will increase robustness and significantly decrease the risk of neck pain

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