Which intervention is NOT supported in the acute management of whiplash associated disorders?

• A. Modalities to reduce pain and guarding
• B. Cervical mechanical traction
• C. Soft tissue mobilization in the acute stage
• D. Education and gentle ROM as pain allows

Answer: (B)

In the acute stage of whiplash, the main aim is to control pain and muscle guarding while keeping the neck moving within tolerable limits. Interventions that help reduce pain and prevent guarded, protective postures make it easier to progress to gentle, nonPainful movement. This includes modalities such as ice or heat and other analgesic approaches, which can calm inflamed tissues and reduce spasm enough to allow safe activity.

Cervical mechanical traction is not supported in the acute phase because there’s little evidence of benefit and it can irritate tender neck structures, potentially increasing pain and discomfort. In early healing, applying traction can disrupt the protective muscle co-contractions and facet joints, making movement harder rather than easier. The focus instead stays on gentle modalities that reduce pain, gentle soft tissue work if tolerable, and education with gradual, pain-limited range of motion.

Soft tissue mobilization in the acute stage can be appropriate when performed very gently and within pain limits to help decrease muscle tension and improve comfort, but it must be cautious to avoid provoking symptoms. Education and letting the patient perform gradual, pain-free ROM as allowed by symptoms are essential to prevent stiffness and support recovery.