I was in a bad car accident two years ago. I've never fully recovered. I still have headaches, dizziness, and constant pain. X-rays were taken but didn't show anything. I've tried acupuncture and craniosacral therapy but nothing helps. What do you think I should do next?

You have described what sounds like a whiplash associated disorder (WAD). The first step would be to get an accurate diagnosis of what's going on. Although the X-rays were normal, there could be some soft tissue damage that doesn't show up on plain radiographs. You may benefit from more advanced imaging such as magnetic resonance imaging (MRI). The MRI can show the discs and soft tissues of the cervical spine more clearly than other types of imaging studies. If there are any torn or damaged ligaments, the signal intensity of the MRI will change indicating a problem. The results of more definitive testing should help guide treatment. If there is no obvious ligament, disc, or bone damage, then you may be a good candidate for physical therapy. The therapist will help you regain full motion, strength, and function. Restoring normal motor control is also an important part of rehab for chronic head and neck pain after a whiplash injury. Give conservative (nonoperative) care at least three to six months to make a difference. If it does not change your symptoms or alleviate your pain, then you may be a candidate for surgical intervention.

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