Dizziness from whiplash is a complex topic that includes multiple possible root causes of dizziness or vertigo. After a whiplash injury, there are potentially multiple root causes of dizziness that can co-occur, such as cervical dizziness, concussion, and BPPV.

The neck has multiple anatomical structures that can contribute to cervicogenic dizziness or cervical vertigo, such as bony alignment, muscles, and fascia. For that reason, a multidisciplinary team of healthcare providers may be needed to maximize the recovery from whiplash-associated dizziness.

Initial Access to Health Care


The initial entry point into the health care system after a whiplash injury may be through the emergency room or urgent care. 
If emergency or urgent care is not needed, the entry point may be through an appointment with the primary care physician.

In many states, patients can directly access physical therapy without a physician’s referral. In that case, the physical therapist may be the entry point into the health care system for people with whiplash-associated dizziness.

Multidisciplinary Team Approach


Orthopedic manual physical therapy is typically beneficial for patients with whiplash-associated dizziness. The patient may need to get medical clearance before starting orthopedic physical therapy.

A referral to an orthopedic doctor may be helpful to assess the neck for whiplash-associated dizziness. The orthopedic doctor may also order special tests, such as neck x-rays or MRI.  If patients prefer chiropractic care over physical therapy, they may choose a chiropractor as their provider of choice for whiplash-associated dizziness instead of an orthopedic manual physical therapist.

Concussions often co-occur with whiplash-associated dizziness. A referral to neurology for purposes of assessing for or ruling out a concussion may be helpful. The neurologist may order special tests, such as a brain MRI.

If headaches, migraines, or vestibular migraines develop or worsen after a whiplash injury, a neurologist, orthopedic manual physical therapist, or chiropractor may be able to help.

BPPV often co-occurs with whiplash-associated dizziness and concussions, so it should be ruled out or treated. Patients that are experiencing spinning or having brief episodes of intense dizziness lasting less than a minute, provoked by specific positions and movements, may benefit from a vestibular physical therapy evaluation.

Upper Cervical Care


Patients may need to seek specialized health care to address upper cervical dizziness.

I discuss that topic more in this blog.

I share about who can help in this blog.

Seeking upper cervical care may help reduce recurrent BPPV in patients with whiplash-associated dizziness.

Upper Cervical Instability


Upper cervical instability should always be considered for whiplash-associated dizziness.

This article published by an upper cervical chiropractor in Denver has some helpful information on cervical instability, including diagnosis and treatment options.

Soft Tissue Work for Muscles and Fascia


For people dealing with whiplash-associated dizziness, sometimes tension in the fascia needs to be released.
Muscle trigger points may also contribute to dizziness and may need to be addressed to maximize recovery.

Professional health care to release tension in fascia and muscles is called soft tissue work. That may help your neck adjustments hold in place and relieve some dizziness.

Massage can also help, but may be more for relaxation. Soft tissue work is usually targeted with therapeutic value to release the specific muscles and fascia that are contributing to whiplash-associated dizziness.

For soft tissue work, I like to refer my patients to soft tissue providers who are trained in active release techniques. This website has a directory of practitioners and explains the technique.

Myofascial release is also helpful for some people.

Active release technique and myofascial release are my two preferred methods of soft tissue work for the relief of whiplash-associated dizziness.

I hope that you find the right multidisciplinary team of healthcare providers and gain insight, so you can get relief as soon as possible!

Disclaimer

This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.

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