Is there a best type of therapy when time and money are limited? Starting with a particular type of injury, whiplash (usually resulting from a rear-end collision), I recently reached out for a professional response and fortunately received responses from a Calgary Physiotherapist and a Calgary Chiropractor. I tried to word the question as simply as possible: “IN YOUR OPINION, WHAT IS THE BEST TYPE OF THERAPY FOR A WHIPLASH INJURY?” and I requested a brief, point-form response, because this is a blog, not a book.
1) Adam Mann, Physiotherapist MScPT, Market Mall Physiotherapy, 328 – 4935 40th Ave N.W. Calgary AB, emailed me the following:
* As movement experts, physiotherapists specialize in assessing and treating a range of neuromuscular conditions including concussion, whiplash (WAD) and orthopedic injuries.
* Physiotherapists are equipped with manual therapy techniques, modalities and exercises to reduce pain and restore restrictions in range of motion.
* Research shows that specific active exercise is a cornerstone to reduce pain and restoring tissue dysfunction. Physiotherapists are especially suited to treat and assess whiplash injuries.
* Whiplash Associated Disorder is a broad diagnosis. Every victim of whiplash experiences individualized symptoms. There is no one treatment protocol that fits every case. Clients may benefit from other disciplines such as massage, chiropractors, and psychological services.
* In short, physiotherapy is a primary point of care for most whiplash victims and interdisciplinary care can be useful in certain cases.
2) Dale MacDonald, Chiropractor and Sport Specialist, B.A., DC, CSCS, FRCCSS(C), ICSSD, Elite Sport Performance, 530 – 10333 Southport Rd. S.W. Calgary AB, emailed me the following:
I follow the Canadian Chiropractic Guideline Initiative (CCGI) for my approach to managing whiplash associated disorders (WAD). This is an evidence based approach that recognizes the importance of treatment (including cervical manipulation and soft tissue work), a customized strengthening program and patient education on good spinal hygiene as contributors to a good clinical outcome. I’m attaching a link to some good videos here: https://www.canadianchiropractor.ca/education/ccgi-launches-exercise-videos-based-on-neck-pain-whiplash-guidelines-4571
I’ve also attached the full 2016 clinical guideline for whiplash for your reference. (*Treatment-of-NAD-and-WAD_A-clinical-Practice-Guideline.pdf) [this article is 3MB, so I can only cite it here] I hope this helps!
It sounds to me like each of the above professionals has an open-minded approach, which I applaud, tailoring his treatment to the specific patient’s needs. From a legal point of view, assuming that my client’s physician has recommended therapy, an injured client is required to mitigate injuries i.e. do her or his best to heal as quickly or as well as possible. Gone are the days of a physician recommending just pain medication and hot baths. My client must take an active approach to healing and will be faulted by the wrongdoer’s insurer for failing to do so. An active approach will often include more than one modality of treatment, customized therapy, home exercises and regular therapy attendances. My client must also report frequently to her or his family physician in addition to attending therapy. If there isn’t noticeable improvement, further testing may need to be done, therapy may need adjustment and pain medication may be necessary. Emotions must also be addressed. Further modalities are also essential if my client has suffered a brain injury and other head-centered injuries in addition to whiplash. For example, many of my clients are referred to neurologists, optometrists, audiologists and dentists.
So the answer isn’t as simple as the question, which isn’t a surprise.
I thank Adam and Dale for their input!