Collar

Rating

Category: Allied Health Options

Injury Type: Acute

What is it?

A soft or semi-rigid collar placed around the neck to provide support and restrict movement, usually in the early stages after an injury. It may be worn either continuously or for prescribed periods throughout the day and/or night.

How does it work?

The collar immobilises the neck, allowing the injured structures of the neck to rest and thus may potentially aid in recovery.

Is it effective?

Several studies have compared the use of various types of collars to early mobilisation, exercise programmes and advice to "act as usual" within the first 2-3 weeks after whiplash. Four studies found that immobilisation with a collar is inferior in terms of reducing pain, stiffness and disability associated with whiplash. Three other studies found no difference between the use of a collar and the other treatments in terms of pain, range of motion and disability. Two studies reported that people wearing a collar took on average longer to return to work than those who did not, whereas another 2 studies found no difference. One study found that commencing neck range of motion exercises soon after injury lead to improved range of motion at 3 years post-injury when compared to resting and wearing a collar. Overall the research does not support the use of a collar following whiplash injury.

Are there any disadvantages?

It is possible that wearing a collar may increase neck stiffness by preventing movement, therefore potentially delaying recovery and increasing the amount of time it takes to return to work after a whiplash injury.

Where do you get it?

Collars may be provided by the hospital, or by your treating therapist. Collars are available to purchase at most pharmacies/chemists.

Recommendations

The use of a collar is not recommended by research evidence as it may unnecessarily slow recovery.

Key References

  • Bonk, AD, Ferrari, R, Giebel, GD, Edelmann, M & Huser, R 2000, 'Prospective, randomized, controlled study of activity versus collar, and the natural history for whiplash injury, in Germany', Journal of Musculoskeletal Pain, vol. 8, no. 1-2, pp. 123-132.
  • Borchgrevink, GE, Kaasa, A, McDonagh, D, Stiles, TC, Haraldseth, O & Lereim, I 1998, 'Acute treatment of whiplash neck sprain injuries: a randomized trial of treatment during the first 14 days after a car accident', Spine, vol. 23, no. 1, pp. 25-31.
  • Crawford, JR, Khan, RJK & Varley, GW 2004, 'Early management and outcome following soft tissue injuries of the neck-a randomised controlled trial', Injury, International Journal of the Care of the Injured, vol. 35, pp. 891-895.
  • Dehner, C, Hartwig, E, Strobel, P, Scheich, M, Schneider, F, Elbel, M, Kinzl, L & Kramer, M 2006, 'Comparison of the relative benefits of 2 versus 10 days of soft collar cervical immobilization after acute whiplash injury', Archives of Physical Medicine and Rehabilitation, vol. 87, no. 11, pp. 1423-1427.
  • Guzman, J, Haldeman, S, Carroll, L, Carragee, E, Hurwitz, E Peloso, P, Nordin, M, Cassidy, D, Holm, L, Coˆte, P, Van der Velde, G & Hogg-Johnson, S 2008, 'Clinical practice implications of the bone and joint decade 2000–2010 task force on neck pain and its associated disorders; from concepts and findings to recommendations', European Spine Journal, vol. 17, no. 1, pp. 199-213.
  • Hurwitz, E, Carragee, E, Van der Velde, G, Carroll, L, Nordin, M, Guzman, J, Peloso, P, Holm, L, Coˆte, P, Hogg-Johnson, S, Cassidy, D & Haldeman, S 2008, 'Treatment of neck pain: noninvasive interventions; results of the bone and joint decade 2000–2010 task force on neck pain and its associated disorders', European Spine Journal, vol. 17, no. 1, pp. 123-152.
  • Kongstead, A, Qerama, E, Kasch, H, Bendix, T, Winther, F, Korsholm, L & Jensen, TS 2007, 'Neck collar, "act-as-usual" or active mobilization for whiplash injury', Spine, vol. 32, no. 6, pp. 618-626.
  • Leach, J 2007, 'Editorial comment on "developing clinical guidelines for the physiotherapy management of whiplash associated disorder (WAD)" by C. Mercer, A. Jackson and A. Moore', International Journal of Osteopathic Medicine, vol. 10, no. 2-3, pp. 55.
  • Mercer, C, Jackson, A & Moore, A 2007, 'Developing clinical guidelines for the physiotherapy management of whiplash associated disorder (WAD)', International Journal of Osteopathic Medicine, vol. 10, no. 2-3, pp. 50-54.
  • Motor Accidents Authority 2007, Your guide to whiplash recovery in the first 12 weeks after the accident, MAA, Sydney, Australia.
  • Schnabel, M, Ferrari, R, Vassiliou, T & Kaluza, G 2004, 'Randomized controlled outcome study of active mobilization compared with collar therapy for whiplash injury', Emergency Medicine Journal, vol. 21, pp. 306-310.
  • Vassiliou T, Kaluza, G, Putzke, C, Wulf, H & Schnabel, M 2006, 'Physical therapy and active exercises – An adequate treatment for prevention of late whiplash syndrome? Randomized controlled trial in 200 patients', Pain, vol. 124, pp. 69-76.
  • Verhagen, A, Scholten-Peeters, G, Van Wijngaarden, S, De Bie, R & Bierma-Zeinstra, S 2007, 'Conservative treatments for whiplash', Cochrane Database of Systematic Reviews, Issue 2, Art. No.: CD003338. DOI: 10.1002/14651858.CD003338.pub3.
  • Yadla, S, Ratliff, J & Harrop, J 2008, 'Whiplash: diagnosis, treatment, and associated injuries', Current Reviews in Musculoskeletal Medicine, vol. 1, pp. 65-68.
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