how to treat an old whiplash injury

Hi there,

I'm wondering if you guys can help. My mum was in an accident about a year ago, where the mini bus slip on the road due to ice being on the road. She was flung forward in her seat. The bus slipped in total twice and on the second time the bus did a 360 circle on the road.

Since then, my mother has been complaining about a sore/tight neck for a long time and it has been gradually got worse of the last couple of months. I believe that she has had an untreated case of whip lash which has now become an old injury. I have tried to get her to see a physio to try to diagnose her injury and have failed miserably each time I recommend her to go and see one.

I would be interested in seeking your views on how to treat this and what sort of things you would try. And would it be better for my mum to see a physio who specialises in lumbar spine injuries or specifically someone who deals with neck and shoulders? Some other issues for consideration is that she has slight osteoporosis and poor muscle mass.

Many thanks

Angie

Hi Angi
It seems to me not a bad idea for your mother to seek help of a physio and preferably of 1 who sees neck/shoulders on a regular basis. I do get the impression your mother is not keen on seeing a physio (or are`there other reasons to fail to attend the appoinment). Maybe your mother has bad memories of hospitals, maybe she doesn't know what a physio does, name it.
I think you have told: Whiplash 1 year ago, ever since tightness and soreness of the neck, worsened since a couple of months. Poor musclemass and slight osteoporosis.
Before being able to give you any answer: How about movements of the neck/head (e.g. some painful, restricted) ? Can she get relief from or aggrevate the symptoms? Has she always pain (in the neck)or e.g. more in the morning then in the evening, how does she react in general on pain/ discomfort? What sort of pain (e.g. sharp/dull)? Has she as well pain in other areas like headaches and shoulder pains ( radiating sensations down arms, e.g. numbness/pain) How old is your mother? History of earlier problems in the area? Any examinations (e.g. x-rays) after the accident? Any treatment?

Angie,

I would have thought that your mothers main issue is her strength around the neck. Any 'inury' will have healed this far down the line, so unless she has done anything else to her neck since it is unlikely that this is her source of pain. When you have an injury, the surrounding muscles tend to weaken due to lack of use, usually related to pain. Due to this when you use the muscles and you use the neck muscles most of the day, you ask them to do more than they are strong enough to do, this will cause muscle spasm and therefore pain.

What I suggest she does is make sure her neck is always supported - e.g. use the headrest when she drives, roll us a towel or use a cushion when sat on the sofa and ensure the neck is in aligment when sleeping. She also needs to avoid any cold draughts as that will make her tense up and use heat on the neck area when she is in pain.

But the thing that will fix her is to see a physio that can strengthen up the required muscles and that should hopefully reduce the problem.

Hi guys,
Thank you for your responses.
My mother has never seen a physio before and I think that it would be good for her to see a physio who does neck and shoulders or back. I think it is more the issue for the effort to get to the physio which is silly than anything else.

I had suggested that she shoulde see my physio quite some time ago but she decided against it as she thought tht it had got betterand then her neck got worse again. She has agreed to see one but where I live it is hard to find a good physio. My physio has unfortunately left and I am now going to see a physio who works with swimmers and deals with over use injuries and shoulder and neck pain but once again my mother is unsure of the benefit which is why I wanted to do some research and ask the physio's here.

In relation to your questions her movement is very tight in the neck and head. If you try to palpate it around the scalene muscles and upper traps they are so tight she can barely feel me getting my fingers in there to try to release them. Heat does seem to relax her neck quite a bit. I think that the pain comes more in the evening and gets veryt tight when she goes to sleep. the pain usually disrupts her sleep quite a bit.

She doesn't have any pain or other areas like headaches and shoulder pain. no numberness down the arm but weakness in her arms with certain movements. X rays did not show any inflammation of the bone nor did the cat scan. It showed some osteoporosis on the c4-5 and in the lumber region but that is about it. Mum is 59, she has had no history of problems in this area until recently but bear in she was a public servantfor quite some time and so she has poor posture and a slightly forward neck.


I agree that her neck does need to be supported especially when driving and also when sitting on the couch. Mum had asked the sports doctor to give her a neck brace and he laughed at the thought of it. Not a very nice sports doctor is all I have to say. when she is sleeping, would you still roll a towel and put it under her neck?

Thanks for all your help.
Angie

Hi Angie,

I'm sorry to hear you mother is having trouble. Seeing a physio definitely sounds like a plan, although to see improvements will require effort to do the exercises to correct posture, regain range of movement and strengthen the area. Sleeping with a rolled towel under her neck at night would be good as well to try and avoid her assuming any aggravating positions.

I see you mentioned a neck brace above. That the sports doctor laughed I agree is not nice at all, and could definitely use some work on his interpersonal skills! However, for management of neck problems here in the UK I think neck braces are avoided where possible, as immobilising the neck is thought to increase stiffness and pain further. I did a quick search and found that evidence is as usual conflicting, however many papers advocate exercise over restriction. I have attached a paper which provides somewhat of a summary on whiplash - although it is now 6 years old and is by no means definitive (i didn't have access to newer ones), it does discuss some of this issues in the development and treatment of whiplash.

Hope this was helpful and good luck with it

Rachie

Hi Rachie,

Thanks for all your help. I agree that my mum needs to stick to a rehab pan in order to get the maximum benefit out of it. It is something which she does not quite understand, however I will work on tht one. It is sad that the sports doctor who was well known in my hometown does not have very good interpersonal skills, I hsould have known because when I saw him, he started an argument with me about the need to have a cortisone injection which would apparently fix the aggravation and pain I was getting in my shoulder. I thought that he might of just been having a bad day but it turns out that I was quite wrong about thatone.

Thanks for also sending me the article. I'll have a read of it tonight and then go from there. It's interesting o see that some are really for and others are against the idea of using a neck brace.

Angie