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Still Clueless about Whiplash

Whiplash--now that's a diagnosis that's easy to understand, right? Wrong. Very, very wrong. As the authors of this article point out, medical professionals don't even agree on the exact definition of whiplash. Everyone agrees that it happens most often in car crashes. But nobody knows exactly what happens in the body to cause prolonged pain and disability. Doctors and therapists don't even know which treatments work best to get whiplash patients back to full function--there aren't enough good studies.

These authors searched the medical literature to find clinical studies using conservative treatment for whiplash. Conservative treatments for whiplash include heat and ice packs, ultrasound, exercise, traction, and massage, among other therapies. The authors located only three studies that were good enough to be considered in detail in this review. The three studies looked at pulsed electromagnetic therapy, a combination of conservative treatments, and encouraging normal activity.

Overall, the authors found the studies of low quality and not very useful. The strongest conclusion from the three studies is that activity is probably better than rest and strict immobilization for whiplash patients. The authors' main conclusion is that there is a glaring need to better understand treatment for whiplash. Based on their review, they suggest that future clinical trials should follow patients for a year and measure social and psychological outcomes as well as physical outcomes. Until better research is done, doctors and therapists have a limited understanding about the best way to treat whiplash.

References: Gwendolijne G. M. Peeters, MSc, MT, et al. The Efficacy of Conservative Treatment in Patients With Whiplash Injury: A Systematic Review of Clinical Trials. In Spine. February 15, 2001. Vol. 26. No. 4. Pp. E64-E73.

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