Assessment and evaluation
Clients who have experienced a whiplash-associated disorder will usually report a single traumatic event that caused their physical problem. It is important that the therapist try to determine the magnitude and direction of the forces that were present at the time of the injury. This information will greatly aid in determining which tissues have received the primary stress.

Physical signs of whiplash include neck ache, shoulder pain, headache, muscle tenderness and spasm, and limited range of motion. If there is injury to the neurological structures, the client may also experience paresthesia. It is not unusual for these signs to persist for a great length of time. Pain will often start 24-48 hours after the injury.

One of the more interesting factors associated with whiplash-associated disorder is the common delayed onset of physical signs. While most signs will come on within 48 hours, it is not unusual for symptoms to occur days, weeks and, in some cases, even months after the initial trauma. There are various explanations for why these signs start much later, including delayed inflammatory response or gradual tissue damage from the initial injury. However, our understanding of this phenomenon is still limited.

In addition, some people experience impairment of memory, concentration or sleep, as well as fatigue, depression and psychological distress. The practitioner should be on the lookout for all these signs.

If not severe, most whiplash conditions are usually limited to soft-tissue distress. Muscles and ligaments may be overstretched or torn. In many instances, myofascial trigger points will develop in the cervical muscles following a whiplash injury. These trigger points will lead to patterns of facilitated muscular dysfunction that will often linger for months or years after the initial trauma.

The practitioner’s skill in taking a detailed history is an essential part of effective evaluation of any whiplash-associated disorder. It is also important to know when to refer to another health-care professional in order to rule out problems that may require their intervention. Because there is a serious possibility of compression fractures, nerve damage or joint dysfunction, the practitioner should identify whether or not any of these conditions need to be addressed in order to design the most effective treatment plan.

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