Neck Pain After a Car Accident
Neck pain is unfortunately a common injury after a car accident. Depending on the severity of the accident, x-rays of the neck may be indicated. Clinicians will likely use the Canadian Cervical Spine Rule to determine if radiographic images are necessary. A dangerous mechanism of injury includes a fall from greater than 3 ft, axial load to the top of the head (diving), a high-speed car accident (>100 kph), rollover accident, ejection from a car, motorized recreational activities, or bicycle struck by a collision. In these cases of a dangerous accident, x-rays will be ordered. After fractures and any other serious, emergent conditions of the spine are ruled out, you may be referred to physical therapy.
In 2017, a new clinical prediction guideline (CPG) was released by the American Physical Therapy Association (APTA). This guidelines suggested that there are three possible outcomes for those who are experiencing neck pain with a whiplash associated disorder. About 45% of people will have mild disability, 40% with moderate disability, and 15% with severe disability. The most recovery will occur in the first 6-12 weeks after the injury which is the critical window for healing and treatment.
There are 5 risk factors that may indicate persistent problems after the injury. The first is a high pain intensity, defined as >6/10 on the Numeric Pain Rating Scale. Second is a high self-reported disability score based on the Neck Disability Index, specifically a score of >30% disability. The third risk factor is high pain catastrophizing. Based on the Pain Catastrophizing Scale, a score of > 20 is a risk factor. Fourth is high acute post-traumatic stress symptoms, and a score of > 33 on the Impact of Events Scale (revised) indicates higher risk for persistent symptoms. The final risk factor is cold hyperalgesia or pain induced with a cold temperature.
Treatment
Now let’s talk about various treatment options for those in the three categories of early recovery, prolonged recovery, and chronic symptoms. In the early recovery group, there is emphasis on staying active and performing pain free mobility. These patients will likely heal on their own with monitoring of symptoms from the therapist. In those with a prolonged recovery, the therapist will emphasize active range of motion, low load strengthening, and manual therapy. It will be important for your therapist to supervise those exercises to ensure proper muscle activation, promote optimal coordination, and increase awareness of proper posture. In the group with more chronic symptoms, education will be emphasized based on the patient’s individual and realistic prognosis. Your therapist will also perform cervical mobilization and individualized progressive exercise.
While there are a lot of specific details in this blog post, it is your therapist’s responsibility to best hypothesize the patient’s prognosis after a car accident. It is especially important to explain the mechanism of injury to the best of your ability and provide a timeline of your symptoms. Your therapist will review this information in addition to your initial paperwork to develop your individualized plan of care for physical therapy.
If you have experienced a motor vehicle accident and need an evaluation, our clinics in Port Orchard and Silverdale will help you know what is the best way to address your injury.
Click here to request an appointment and one of our staff will reach out to you.
Or give us a call at 360-329-7052 to reach our Port Orchard Office or 360-625-9161 to reach our Silverdale Office, both located in Kitsap County
Jill Hoffman PT, DPT is a physical therapist specializing in treating orthopedic conditions
References
- Blanpied, Peter R., et al. “Neck Pain: Revision 2017.” Journal of Orthopaedic & Sports Physical Therapy, vol. 47, no. 7, 2017, https://doi.org/10.2519/jospt.2017.0302.
