Conservative treatment of a patient with previously unresponsive whiplash-associated disorders using clinical biomechanics of posture rehabilitation methods

J Manipulative Physiol Ther. 2005 Mar-Apr;28(3):e1-8. doi: 10.1016/j.jmpt.2005.02.006.


Objective: To describe the treatment of a patient with chronic whiplash-associated disorders (WADs) previously unresponsive to multiple physical therapy and chiropractic treatments, which resolved following Clinical Biomechanics of Posture (CBP) rehabilitation methods.

Clinical features: A 40-year-old man involved in a high-speed rear-impact collision developed chronic WADs including cervicothoracic, shoulder, and arm pain and headache. The patient was diagnosed with a confirmed chip fracture of the C5 vertebra and cervical and thoracic disk herniations. He was treated with traditional chiropractic and physical therapy modalities but experienced only temporary symptomatic reduction and was later given a whole body permanent impairment rating of 33% by an orthopedic surgeon.

Intervention and outcome: The patient was treated with CBP mirror-image cervical spine adjustments, exercise, and traction to reduce forward head posture and cervical kyphosis. A presentation of abnormal head protrusion resolved and cervical kyphosis returned to lordosis posttreatment. His initial neck disability index was 46% and 0% at the end of care. Verbal pain rating scales also improved for neck pain (from 5/10 to 0/10).

Conclusion: A patient with chronic WADs and abnormal head protrusion, cervical kyphosis, and disk herniation experienced an improvement in symptoms and function after the use of CBP rehabilitation protocols when other traditional chiropractic and physical therapy procedures showed little or no lasting improvement.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Arm
  • Biomechanical Phenomena
  • Cervical Vertebrae / injuries
  • Headache / etiology
  • Humans
  • Intervertebral Disc Displacement / etiology
  • Intervertebral Disc Displacement / physiopathology
  • Kyphosis / etiology
  • Kyphosis / therapy
  • Male
  • Manipulation, Chiropractic*
  • Pain / etiology
  • Pain / physiopathology*
  • Pain Management*
  • Posture*
  • Shoulder Pain / etiology
  • Spinal Fractures / etiology
  • Spinal Fractures / physiopathology
  • Thoracic Vertebrae
  • Whiplash Injuries / complications*