This report reviews the physical therapy (PT) treatment received by a patient with whiplash injury. The patient was a 32-year-old woman who had been in a car accident. PT was started two weeks after the accident. At that time, she couldn’t sit for more than 10 minutes. She was unable to do her job as a postal worker because of neck and upper back pain.
Early PT treatment consisted of manual therapy such as soft tissue and joint mobilization. The therapist focused on the upper back area from T1 through T6. These vertebrae form the upper thoracic spine. Problems in this area can cause neck pain and loss of neck motion. The authors provide a detailed description of the treatment used.
After two treatments the patient was able to drive and sit without any pain during the day. Neck motion was better but not normal. Joint manipulation and exercises were added to the patient’s PT program with good results. One week later the patient was able to return to work.
Her remaining symptoms were relieved when the therapist treated the neck area. The authors give a step-by-step description of the treatment used. By the end of the fourth treatment session two weeks later, the patient was pain free. She was also back to her full activities at work and at home.
The authors suggest this case shows how symptoms after a whiplash injury may be coming from the thoracic spine, not just the neck. Manual therapy and exercises returned the patient back to normal in four treatment sessions. This was much faster than results reported in other studies using medications, rest, neck collars, and other forms of treatment.