For far too many victims of whiplash, the injury begins a physical and mental cycle that prolongs pain and harms the healing process. Research has shown that patients who have whiplash-associated disorder (WAD) often suffer from pain avoidance and fear. When patients are afraid of pain, they often restrict the movement in their neck muscles. When movement is avoided, the muscles involved may not heal properly. The further whiplash pain results in more fear and movement avoidance in many patients. This cycle can lead to longer recovery times and a higher risk of disability for WAD sufferers.
In a new study, researchers examined the role of fear after whiplash injuries and assessed the efficacy of three treatments for fear. The study included 191 patients with WAD who were still symptomatic three months after injury.
The patients were divided into three groups. In one group, participants were given an information booklet describing WAD and highlighting the importance of resuming physical activity and movement. The second group also received the booklet, but were also involved in a discussion with a clinician, who reinforced the information in the literature. The last group received the booklet plus therapy for fear desensitization, including imaginary and direct exposure to the feared activities and movements. This group received three fear desensitization treatments of two hours each.
The study results showed that the group who received the exposure therapy had the best recovery. Not only did this group have the most significant reduction in fear; they also reported less pain severity compared to the other two groups.
Due to this connection, the authors of the study concluded that it provided further evidence that fear of movement is tied to prolonged pain in WAD patients. They recommended that fear be treated, and they recognized that exposure therapy and educational interventions may help improve function and aide in recovery of whiplash.
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Robinson J, et al. The role of fear of movement in subacute whiplash-associated disorders grades I and II. Pain 2013; 154(3): 393-401. doi: 10.1016/j.pain.2012.11.011.