I got a whiplash-like injury several years ago and it never really went away. I have both RA and fibromyalgia, so it seems to have created some sort of endless loop of a repetitive strain injury, as well. It is amazing how much such an injury interferes with your ability to live your life.
A couple of things. First, if your PT causes a flare every time you see them, there's a problem. I can see being a little sore after you have physio, but if you have a significant flare, then they're doing something wrong. You may want to find another physiotherapist - look for someone who has experience in dealing with chronic conditions. I've seen a couple, one who was fantastic, respected my limits and work within them, which really helped me. I've also seen one or two who insisted on pushing me past my limits and every time, I paid for it with a flare. The ones who pushed me past my limits worked in orthopedic rehab where such an approach can be warranted, but which should definitely not be used for somebody who has a chronic condition. You know your body better than anyone, so I would suggest that you advocate for yourself and discuss the approach to treatment with your physical therapist - together, you may be able to find another way of treatment that would help you without causing a flare. You have already tried acupuncture, but I would recommend that you continue with that - although it probably won't cure you, it could be a very helpful in pain management.
What ended up helping me was ultrasound. I got to the point where I was thinking about quitting my job would MyRACentral because working aggravated my injury so much. My doctor gave me a last-resort referral to ultrasound with a physical therapist - she didn't think it would work, but it was one of those "we've tried everything else" cases. And then it did work. This may be one of the things you can suggest to your PT.
even though I am much better now, I still need to be careful and listen to my body to avoid triggering a flare of the problems. Muscle relaxants also an essential part of how I manage the problems in my neck and shoulders - I take cyclobenzaprine every night before go to bed and it helps unclench whatever I did during the day so I'm better in the morning. I always wear a scarf to keep my neck warm and protected against drafts. Heat and ice are also helpful, as is meditation.
Keep in mind that you may have some degree of these symptoms for a long time. Perhaps if you approach it as a sort of chronic condition, utilizing a number of different ways of dealing with it like the ones I described above, they will work together and help reduce the symptoms.
good luck! Please keep us posted on what happens?
Well my chiropractor is actually using laser treatments and that has helped immensely. It basically reduces the inflammation in that body part (my neck) and the more you do it the more it helps. He isn't even able to adjust my neck because it will flare for several days. I call my chrio a magician because he really does have magic hands! He is so nice, too. Always willing to listen to me and very supportive of my healing, even when I come to him in tears.
My phsyc. therapist called and said she is dropping me down to once a week (I was going 2) because of the flare, but I'm still weary. This is my 3rd PT place. I'm also waiting to heal so I can finish up my settlement. My lawyer is sort of pressuring me to settle since it's been over a year. She wants my doctor to sign a paper saying I have permanent damage, but I'm weary of that!
Thanks for your support :)
I'm so sorry you are one of us who has had a whiplash injury. I would say it is one of the most painful, life disrupting things I have ever experienced. I, too, was in an auto accident years ago, and suffered whiplash. Unfortunately, it never completely heals, or that has been my situation, anyway. My RA meds have helped my whiplash a lot, but when it flares, the best thing I have found for relief is a muscle relaxant. When my muscles in my neck knot up and move down my shoulder, I take the muscle relaxants on a regular basis until it is under control and then I just take one every night before bedtime. The muscle relaxants also help w/TMJ. It doesn't sound to me as though your PT is helping you. They must be doing something wrong...??? I can feel the pain in your writing. I am so, so sorry. Please talk to your doc and perhaps he/she will prescribe some muscle relaxants for you. Please let us know how you are doing.
Sorry to hear about your injury. I am a PT with long term experience in treating neck problems. As is usually the case Lene has given you very good advice. This is a job for a good PT. She is also right in the fact that some of them are too aggressive with injuries like this.
In severe whiplash the soft tissues around the neck are overstretched or torn and can be slow to heal. The problem comes in when they heal in a shortened position and essentially immobilize your neck. Then when you try to move the tissue is going to become inflammed and painful all over again. As you know this will give you severe pain,headaches,dizzyness and all sorts of problems.
How is your range of motion? Is your movement restricted in all directions or just a couple of directions? If you have full range of motion and are still having lots of pain there is probably an underlying problem that needs to be diagnosed. If you are restricted in movement you are going to have pain until your neck loosens up. To start with PT can use things like ultrasound and other modalities to help heal and relax the injured tissues. At the same time you need to work on re-gaining your mobility. Check your movement in all directions and begin working on the least painful movement with gentle range of motion exercises. Examples are slowly turning your head as far as you can 5-10 times. When this gets easier turn your head and then tilt your chin down at the end of your range. Hold this position for a few seconds. Movements need to be slow and you should expect some discomfort but not severe pain. Things like this need to be repeated several times daily because the tissue will rapidly go back into a shortened position. Provided there is no underlying structural damage you should be able to slowly unlock your neck and as you do the pain will subside. If you are wearing a cervical collar it can begin to work against you after a period of time by not allowing you to move. You might want to try leaving it off more at home but you will still need it when in a car.
These are some general guidelines and I hope they will help. At this point waiting for it to get better before you get on with your life is not going to work. You need to make it be your neck again. Obviously I have not had the opportunity to actually evaluate your neck so if anything I said goes against any precautions you have been given due to underlying injuries you should not go against your precautions.
I wish you a full recovery.
I've never been given any stretches to do. Just exercises. One is where I pull my head back to make my neck straight with shoulders back (hold for 5 secs x5 reps) every hr. One is to do that lying down and then to roll my shoulders back. We do more exercises when I go in, but the little we do flares me up! I'm pretty sure I don't have any underlying conditions (besides RA and fibro) because I've been seen by many doctors and have had xrays/Ct scan. Thanks for your help! Do you think I should continue PT?
I do think you should continue PT but be an active patient and take charge. Ask your PT about using modalities such as ultrasound to promote healing and relax the tissues. Also working on active (you do it) range of motion exercises to get you moving in all directions again. If you don't feel like the PT is doing what you need tell them, you know your body better than anyone else. If you are not satisfied move on to someone else. The trick at this point is to not let this injury make you a professional patient where you are waiting for someone else to make you better. Put yourself first and push to get your life back.
Best of Luck