Clinical Chiropractic 2004 (Mar): 7 (1): 16—23
Redland House Clinic,
118 Redland Road,
Redland, Bristol BS6 6QT, UK
Hyperflexion/extension injuries are common and often result in neck and low back pain. As a neuromusculoskeletal complaint, chiropractors, as primary healthcare clinicians, are increasingly providing treatment in such cases. In the case described, a 22-year-old female presented 3 years after a ‘whiplash’ type injury complaining of chronic neck pain and stiffness and frontal headaches. The neck pain had commenced 24 h after a road traffic accident (RTA) and had remained severe for 2 weeks, during which time a soft collar was worn. The neck pain and stiffness had persisted and had worsened in the 6 months leading up to presentation. In addition, frontal headaches had also developed.
This case demonstrates that chronic ‘whiplash’ injury patients can respond well to appropriate conservative management, even in the presence of poor prognostic indicators. The management protocol in this case consisted of chiropractic spinal manipulative therapy, soft tissue work and post-isometric relaxation (PIR) techniques to address biomechanical somatic dysfunction. In addition, active rehabilitation exercises, self-stretches and proprioceptive exercises were utilised to address postural and muscle imbalance. On the seventh treatment, the patient reported no neck pain, no headaches and unrestricted cervical spine range of motion. At 4 months follow-up, the patient continued to be free of headaches and neck stiffness and reported only mild, intermittent neck pain. This case demonstrates the use of chiropractic management of chronic ‘whiplash’ type injuries. However, more high-quality evidence is required to support the use of chiropractic care for chronic and, indeed, acute ‘whiplash’ cases.