What are the recommended initial management strategies for patients presenting with whiplash-associated disorders?

Initial management strategies for patients presenting with whiplash-associated disorders include:

• Early assessment: Evaluate the patient for any signs of cervical spine injury or neurological deficits using clinical criteria such as the Canadian C-spine rule to determine the need for imaging and immobilisation.²
• Imaging: Perform urgent imaging (usually CT cervical spine) if high-risk factors for cervical spine injury are present or if the patient cannot safely be assessed clinically.¹,²
• Spinal protection: Maintain cervical spine protection with manual in-line immobilisation during assessment and transport if spinal injury is suspected.²
• Pain management: Assess pain regularly and offer appropriate analgesia early, starting with medications such as morphine if needed, adjusting doses to achieve adequate relief.²
• Encourage early mobilisation: Advise patients to remain active and avoid prolonged immobilisation or use of rigid collars, as early movement is associated with better outcomes in whiplash-associated disorders.¹
• Patient education: Inform patients about the generally favourable prognosis and encourage self-management strategies to reduce fear and promote recovery.¹

These strategies aim to identify serious injury promptly, provide symptom relief, and prevent chronicity by promoting early return to normal activities.¹,²