From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
The management of an acceleration-deceleration injury should prioritize early mobilization, pain control, and gradual return to normal function, as supported by the most recent and highest quality study available 1.
Key Components of Management
- Pain management with mild analgesics such as acetaminophen (500-1000mg every 6 hours, not exceeding 4g daily) or NSAIDs like ibuprofen (400-600mg every 6-8 hours with food) 1
- Muscle relaxants such as cyclobenzaprine (5-10mg three times daily) may be added for severe muscle spasm in the first few days
- Contrary to traditional practice, prolonged immobilization with cervical collars should be avoided; instead, they should only be used for severe cases and limited to 72 hours maximum
- Early mobilization through gentle, active range-of-motion exercises should begin within 24-48 hours after injury to prevent stiffness and promote healing
- Physical therapy focusing on gradual strengthening, posture correction, and proprioception training is beneficial for most patients and should begin within 1-2 weeks post-injury
- Application of ice in the acute phase (first 24-48 hours) for 15-20 minutes every 2-3 hours can reduce inflammation, followed by heat therapy in later stages to relax muscles
Rationale
The approach is recommended because early movement prevents chronic pain development by reducing muscle guarding and promoting proper tissue healing, while appropriate pain management allows patients to participate in rehabilitation activities essential for recovery 1. The deceleration index, a new metric being used by some physical therapists and rehabilitation specialists, may also be beneficial in improving patient outcomes by focusing on the ability to decelerate as a key component of successful rehabilitation 1.
Considerations
- The study by 2 provides insight into the course of the traumatising force in acceleration head injury, but its findings may not be directly applicable to the management of acceleration-deceleration injuries.
- The study by 3 discusses the effect of acceleration/deceleration trauma in angioid streaks, but its relevance to the management of acceleration-deceleration injuries is limited.
- The study by 4 highlights the potential risk of myopathy associated with high-dose methylprednisolone in acute spinal cord injury patients, which may be a consideration in the management of acceleration-deceleration injuries.
- The study by 5 investigates the occurrence of whiplash injuries in low-speed rear impacts, but its findings may not be directly applicable to the management of acceleration-deceleration injuries.