Is Advice Equal to Comprehensive Physiotherapy for Chronic Whiplash?

The management of patients with whiplash-associated disorders is challenging. Acute whiplash transitions into a persistent disorder in 40% to 60% of cases (Pain 2013; 154:1798). No significant change in recovery status is seen after the first 3 to 6 months. The annual cost of whiplash injuries in the U.K. is £3.1 billion, consisting primarily of health costs for people who develop chronic symptoms and to loss of work (Lancet 2013; 381:546).

In this pragmatic, randomized, controlled trial, researchers randomized 172 patients with symptoms of grade 1 or 2 chronic whiplash lasting 3 months to <5 years to receive either 20 sessions of a comprehensive exercise program or one session of advice plus telephone support. The primary outcome was pain i…