The term soon began to be utilized as a condition rather than the force itself. The term Whiplash Associated Disorder (WAD) encompasses the collective symptoms that affect the head and neck after a Whiplash injury. So, Whiplash is a force whereas WAD is termed to describe the conditions and presentation of the injury.
Any delays in getting evaluated and treated by a licensed physical therapist result in impaired cervical mobility, pressure hypersensitivity, the development of chronic pain, trigger points in the neck and arms, and headaches. It is not a surprise that whiplash injuries, though significantly painful, are often accompanied by diagnostic workups without any major structural pathology to the spine. The reason behind this is the complex phenomenon of how pain is generated, and transmitted and the associated factors that make it intense.
Whiplash Associated Disorders are classified into the following categories by the Quebec Task Force
Grade 0 : No complaint about the neck. No physical signs.
Grade I : Neck complaint of pain, stiffness or tenderness only. No physical sign(s).
Grade II : Neck complaint AND musculoskeletal sign(s). Musculoskeletal signs include decreased range of motion and point tenderness.
Grade III : Neck complaint AND neurological sign(s). Neurological signs include decreased range of motion and point tenderness.
Grade IV: Neck complaint AND fracture or dislocation.
Higher grades in WADs will require more intensive treatments and longer recovery and may have a poor prognosis.
Licensed physical therapists with knowledge of this area will perform careful examinations to evaluate the structures involved, source of pain, mobility restrictions, musculoskeletal and neurological signs, neurodynamics, palpable tenderness, pressure sensitivity, vertebrobasilar insufficiency, etc.
Grade 1-3 WADs are usually successfully treated with multimodal physical therapy interventions with notable improvements in cervical spine pain, headaches, neurological signs, musculoskeletal signs, range of motion, strength, etc.
Referrals are made to specialists when tested positive for neurological involvement, grade 4 WAD, positive sign for VBI, or worsening symptoms.
References:
Fernández-Pérez AM, Villaverde-Gutiérrez C, Mora-Sánchez A, Alonso-Blanco C, Sterling M, Fernández-de-Las-Peñas C. Muscle trigger points, pressure pain threshold, and cervical range of motion in patients with high level of disability related to acute whiplash injury. J Orthop Sports Phys Ther. 2012;42(7):634-641. doi:10.2519/jospt.2012.4117
Pastakia K, Kumar S. Acute whiplash-associated disorders (WAD). Open Access Emerg Med. 2011;3:29-32. Published 2011 Apr 27. doi:10.2147/OAEM.S17853
“Advance Therapy blogs and clinical information are educational resources by Advance Therapy clinical employees. The content provided here represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice, and should not be relied on for making personal health decisions.”
Leave A Comment