Why me? Chronic Pain and Whiplash
I recently attended an excellent course in Victoria, BC. The instructors were two experienced physiotherapists who are pursuing PhDs at University of Calgary in the area of chronic pain and whiplash, Ashley Smith and Geoff Schneider. The course was titled Physiotherapy and Complex Whiplash. Ashley now focuses his practice on assessing and advising people with pain persisting for many months following traumatic neck injury, typically people who have had motor vehicle accidents and are at least 18 months post-injury. He founded the Advanced Spine Clinic in Calgary where he works with a team of people including medical pain specialists and psychologists. The course was an excellent mix of review of current research and practising some useful practical assessment and treatment skills.
There has been a lot of research in the past 15 years, that is starting to remove some of the myths surrounding persistent symptoms post whiplash (at least 3 months) and to confirm some of the factors which we thought made people more likely to experience chronic symptoms. The list below is not exhaustive but could help speed your recovery.
What factors can you influence that affect recovery?
- Not wearing a seatbelt
Wear your seatbelt. It keeps you in the vehicle and improves your chances for a timely recovery.
Are you someone who tends to think the worst-case scenario is going to happen to you? This type of thinking is associated with slow recovery. The good news is that you can often change this type of thinking, with practice and feedback from those around you. Sometimes people benefit from additional help from a mental health professional such as a psychologist. Ask your doctor or physiotherapist if they think this might be an issue for you?
Depression is common without trauma but is more common post-trauma and can slow your recovery. If you think this could be an issue ask your doctor to assess and advise you. Some people benefit from short term prescription of anti-depressant medication while others benefit from both medication and counselling from a mental health professional.
- Passive coping strategies
If you expect your therapist or doctor to fix you or tend to rely on medication and other passive forms of pain relief , this makes it likely that your recovery will be prolonged or incomplete. You can speed your recovery by following the advice of your doctor and physiotherapist which will typically include advice regarding how and when to return to work and your other normal activities as well as which exercises would be helpful.
As a clinical physiotherapist for the past 24 years, I can confirm that catastrophizing, depression and passive coping can be significant barriers to progress following a whiplash (or any other injury) and that it is critical for you and your health care team to take a holistic approach to your recovery. If you have any questions or comments about this post, feel free to email me at firstname.lastname@example.org.