Traditional methods of treatment
For many years, the cervical collar was commonly used as a treatment for whiplash. However, most practitioners now realize that unless there is a severe level of damage, early, protected mobilization is far more beneficial than immobilization in a collar. When cervical collars are used, whether soft or hard collars, they may set up the scene for further complications from the initial trauma. It is likely for temporomandibular dysfunction, joint adhesions, muscle atrophy, and myofascial trigger points to develop from long periods of immobilization in a cervical collar.

As with many conditions, rest from any offending activity is essential, especially in the early phases after the injury. It is common practice to begin rehabilitation of whiplash injury as soon as the inflammatory phase has subsided; however, this may be difficult to identify in many instances because visible inflammation is mostly absent. A general guideline of waiting 48–72 hours after the initial incident is usually used.

When there is relief of physical pain from various positions other than static rest, some degree of managed treatment can begin. It is important to remember that rest, while beneficial at the outset, is not the road that is most effective for addressing whiplash injuries in the long run. In most cases, whiplash will benefit from early mobilization; and many conservative treatment approaches, such as massage and other forms of soft-tissue mobilization, are very effective after the initial stages of injury.

Various drugs, such as anti-inflammatory medications or muscle relaxants, may be used to treat whiplash pain. Cervical-traction units may also provide relief for whiplash-related problems. This will be especially true when there is compression of the vertebral bodies or facet joints. As the injury rehabilitation progresses, strengthening exercises, such as isometric methods, will be valuable because they provide greater support and stability to the damaged tissues without causing further joint motion. This is particularly helpful if the primary injury involves joint pathology.

Treatment methods that are useful for dealing with the muscular components of whiplash include the many common methods of general relaxation massage, such as effleurage (within the client’s comfort tolerance), myofascial approaches, or static compression techniques for reduction of muscle tightness and neutralization of myofascial trigger points. Muscle-energy techniques and positional-release methods are often beneficial, especially in the early stages of the injury when pain may prevent deeper soft-tissue manipulation.

As rehabilitation progresses, treatment methods using greater muscular effort, such as active engagement techniques, will help the tissues regain their proper tone and function. It will be very important not to be too forceful with these methods, as they can cause further discomfort to the client if they are applied too soon or too aggressively.

It is also important to use great caution when applying treatments to the cervical region, because of the many fragile structures in this area. For example, the anterior neck muscles are often injured in whiplash conditions, and may benefit from direct treatment; however, they are very close to the carotid artery, so treatment in this region requires great attention to detail.

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