Pricier, Intensive Whiplash Treatment May Not Pay Off: Study12/18/12
MONDAY, Dec. 17 (HealthDay News) -- More costly, intensive
treatment is no better than usual care at hastening recovery from
whiplash, a new study finds.
Researchers looked at more than 3,800 British whiplash patients
to compare a more intensive approach to treatment ("active
management") against usual care at 15 hospital emergency
Active management included pain control plus positive messages
about recovery, specific advice on exercise and an early return to
normal activities. Usual care included more nonspecific advice to
exercise, advice sheets with inconsistent information, and no
guidance on expectations for recovery.
Researchers led by Sarah Lamb of the University of Warwick found
little difference in recovery levels between active management and
usual care patients at four, eight and 12 months after initial
treatment in the emergency department.
Nearly 600 patients who still had whiplash symptoms three weeks
after being treated in an emergency department were then assigned
to receive either a single "advice session" with a physiotherapist
or up to six physiotherapy sessions.
The patients who had the physiotherapy sessions had a somewhat
quicker recovery at four months, but not at eight or 12 months. The
physiotherapy sessions also reduced the number of work days lost by
an average of four days over 12 months, according to the study
published online Dec. 17 in
Active management and physiotherapy sessions are more expensive
than usual care and physiotherapy advice, the researchers point
But the study suggests that these extra and more costly efforts
"do not speed recovery. What is more, although additional
physiotherapy, beyond a single advice session, did offer a modest
benefit, it was not cost-effective," Lamb said in a journal news
Her conclusion: "Emergency departments should continue to
provide usual care for whiplash injuries together with a single
follow-up physiotherapy advice session for persisting
An expert in the United States said this type of information is
"In today's economic environment and with the cost of health care skyrocketing, the cost/benefit analysis of a treatment is relevant," said Dr. Victor Khabie, co-director of the Orthopedic and Spine Institute and chief of sports medicine at Northern Westchester Hospital Center, in Mount Kisco, N.Y.
But he added that, "not all whiplash injuries are the same.
Certain patients with more significant injuries may require more
aggressive treatment. It is important for the treating physician to
understand this and create an individualized treatment plan for
every patient with a cervical injury."
The U.S. National Institute of Neurological Disorders and Stroke
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