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New treatments for whiplash

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For physiotherapist Associate Professor Michele Sterling, treating whiplash is all about thinking outside of the box.

The NHMRC-funded researcher, from the University of Queensland’s Centre for National Research on Disability and Rehabilitation Medicine, is currently trialling a combination of dry needling and exercise for chronic whiplash sufferers.

Whiplash is a common term for sudden acceleration–deceleration forces on the neck as a result of rear-end or side impact motor vehicle collisions and driving accidents. The condition is considered chronic when patients are still experiencing pain three months after the injury.

"There are not a lot of treatment options out there," Dr Sterling said. "We’ve shown in the past that a standard physio approach is not effective for a sub-group of people with chronic whiplash. The impact of their accident has wound up the way their central nervous system processes pain, making them hypersensitive to any kind of stimuli."

Dr Sterling said using dry needles was an attempt to "settle down" the nervous system, allowing patients to participate in exercises typically recommended for whiplash. Dry needling involves the insertion of fine acupuncture needles into muscle trigger points in an attempt to deactivate them.

The trial only started last month and currently has five participants but will expand to include 120 over the next year. Some participants receive dry needling, while others receive a "sham" injection – a blunt needle which is not inserted into the muscle.

Dr Sterling said the trial was an example of mixing orthodox with non-orthodox techniques, an approach she has fine-tuned in her research projects.

Along with her colleagues at the Centre for National Research on Disability and Rehabilitation Medicine, Dr Sterling has attempted to find out why some people are more likely to respond to treatment than others.

"I’m a physiotherapist by discipline but I was always interested in the more difficult cases and working out why some people didn’t recover well," she said. "Our research has found that indicators of poor recovery include an altered central nervous system processing of pain, post traumatic stress disorder and stress.

"There is no one-size-fits-all approach for treating whiplash. You need to look at the underlying pain processes and develop a tailored treatment plan, which might involve combining physio with psychology."

Dr Sterling said the overall goal was for whiplash to be effectively treated in primary care and not to develop into a chronic illness.

Future projects will include further investigation of processes underlying persistent whiplash pain including the measurement of inflammatory biomarkers, MRI measures of neck muscles and functional MRI investigation of brain processes in those with chronic whiplash pain.

(Source: University of Queensland: August 2009)

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Posted On: 4 August, 2009
Modified On: 16 January, 2014

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