October 27, 2011 by dailybolusoflr
Use of Cervical Collars After Whiplash Injuries
Patients who sustain minor neck trauma, most commonly after MVC, are often discharged with a diagnosis of whiplash. Whiplash is commonly defined as soft tissue injury related to hyperflexion, hyperextension, or rotation in the absence of fractures, dislocations or intervertebral disk herniation.
Many providers offer patients symptomatic treatment with a soft cervical collar and occasionally, patients will ask for them. Do these collars help patients feel better? Do they hasten return to daily activities? Do they actually harm patients in their recovery?
There are a number of studies that compare immobilization with soft collar with varying periods of rest to early motion with exercise. Multiple small studies cite decreased pain intensity scores in patients who are assigned to early motion exercises in comparison to their matched immobilization patients both immediately (96 hour follow up) and weeks after injury (4-8 weeks). One study also compared “act as normal” activities (ie. No structured exercise routine) to restricted motion with immobilization for 14 days, again with the immobilized group faring worse in pain scores at short term assessment.
There is, however, no data to support that soft collars actually harm patients in their long term recovery.
What to do? Probably up to you and your patient. . .with consideration to early mobilization.
A nice review article can be found here which discusses multiple references detailing the above studies. Curr Rev Musculoskelet Med (2008) 1:114–119