Comprehensive physiotherapy may not improve whiplash injury

9 Apr 2018

Physiotherapy is the most common rehabilitation treatment offered to individuals with whiplash injuries. Exercise is an important part of a rehabilitation program that might be offered by a physiotherapist. The goals of exercise include increasing flexibility, endurance, strength and mobility. Another important goal of physiotherapy for whiplash injury is to reduce the severity of pain.

It is not clear how many physiotherapy treatments should be offered to someone who has had a whiplash injury. Some individuals might be offered only a few sessions of physiotherapy while others might be offered months of treatment. Intuitively, one might think that more treatment is better than less treatment; but is it? This is the question that was the focus of a large clinical trial led by Professor Michele Sterling and her team at Recover Injury Research Centre.

In this trial, half the patients were provided with a comprehensive physiotherapy program that consisted of 20 sessions of exercise treatment. The patients also received education in self-management skills and instruction in coping skills. The other half of the patients in this trial received one treatment session with a physiotherapist who provided them with advice and guidance on how to remain active. At the end of both treatments, patients’ level of pain and disability was evaluated.

As surprising as it might seem, the group of patients who received 20 sessions of physiotherapy did not improve more than the group of patients who received only one session of physiotherapy. Actually, the results showed that neither group of patients made important gains in treatment.

What is clear from the results of this study is that currently available treatments for whiplash injury are not very effective. The results should not be interpreted as indicating that patients with whiplash injuries only need one session of treatment since improvement in this group of patients was also negligible. The most important message from this study is that there is an urgent need to develop more effective treatments for whiplash injury. The development of new approaches for the treatment of whiplash injury is a major focus of the research that is being conducted at RECOVER Injury Research Centre.



Michaleff Z, Maher C, Lin C, Rebbeck T, Jull G, Latimer J, Connelly L, Sterling M. Comprehensive physiotherapy exercise program or advice for chronic whiplash (PROMISE): a pragmatic randomised controlled trial (ACTRN12609000825257) (2014). The Lancet, 384(9938):133-41