Medication

Rating

Category: Medical Options

Injury Type: Acute/Chronic

Our Rating

Medication Rating
Analgesia
Anti-inflammatories

What is it?

A medication, alternatively a medicine or a drug, is a substance or a combination of substances administered to a human being to cure/prevent a disease or alternatively manage symptoms of a disease/injury. For people with whiplash, common medications prescribed include pain-relieving medications called analgesics and anti-inflammatory medications to control local inflammation.

How does it work?

Analgesics and anti-inflammatory medications are thought to act at the central nervous system (Brain and Spinal Cord) and peripheral nervous system (any nerves beyond Brain and Spinal Cord). Some of the anti-inflammatory medications (such as Aspirin) stop the production of certain enzymes which in turn decrease the production of substances involved in pain and inflammation.

Is it effective?

A recent high quality review looked at the effect of various medications on a range of neck problems, including whiplash. This review found that the evidence to support the use of oral analgesics and anti-inflammatory medications was unclear. However, in clinical practice it is widely acknowledged that for people with whiplash, especially in the early stages, pain relieving medications such as paracetamol can be prescribed. Similarly in severe cases, some anti-inflammatory medications may be prescribed for short term use as a means of controlling pain and swelling.

A recent review found analgesic medication to be effective for short term relief in patients with neck pain without signs of major pathology or trauma. A combination of remifentanil, a low dose opioid (analgesic) and ketamine (an analgesic in low doses) have been shown to be effective in the short term in the reduction of pain associated with whiplash injury.

Are there any disadvantages?

Some of these medications, especially ant-inflammatory medications, may have side effects. These include nausea, vomiting, stomach pain, heart burn, gastritis, abdominal burning, gastrointestinal bleeding, liver toxicity, stomach ulcers and bleeding, ringing in the ears, rash, kidney problems and dizziness or light-headedness. Some of these pain relieving medications can be addictive if taken regularly.

Where do you get it?

Some of these medications are available as over-the-counter medications in supermarkets and pharmacies without a prescription. Others, especially those with higher dosages, require a prescription from a medical doctor.

Recommendations

The evidence to support these medications is unclear. While it seems that pain relieving medication and anti-inflammatory medications may help in symptom management, especially in the short term after whiplash, more research is needed on long term effects. Usage of medications, especially in combination, should be monitored regularly by a qualified and registered health professional such as medical doctor and/or a pharmacist.

Key References

  • Guzman, J, Haldeman, S, Carroll, LJ, Carragee, EJ, Hurwitz, EL, Peloso, P, Nordin, M, Cassidy, JD, Holm, LW, Côté, P, Velde, G & Hogg-Johnson, S 2009, 'Task force on neck pain and its associated disorders', Journal of Manipulative and Physiological Therapeutics, vol. 32, pp. 227-243.
  • Lemming, D, Sorensen, J, Graven-Neilson, T, Lauber, W, Arendt-Nielsen, L & Gerdle, B 2007, 'Managing chronic whiplash associated pain with a combination of low-dose opioid (remifentanil) and NMDA-antagonist (ketamine)', European Journal of Pain, vol. 11, no. 7, pp. 719–732.
  • Motor Accidents Authority 2007, Your guide to whiplash recovery in the first 12 weeks after the accident, MAA, Sydney, Australia.
  • Pelso, P, Gross, A, Haines, T, Trinh, K, Goldsmith, CH, Burnie, S, Cervical Overview Group 2007, 'Medicinal and injection therapies for mechanical neck disorders', Cochrane Database of Systematic Reviews, Issue 3, Art.No.: CD000319. DOI:10.1002/14651858. CD000319.pub4.
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