Drug treatments (analgesics, antidepressants, epidural corticosteroids, epidural local anaesthetics, muscle relaxants, NSAIDs) for acute whiplash injury
In this section:
Antidepressants, NSAIDs, or usual care
compared with manipulation We don't know whether manipulation is more effective than diazepam, azapropazone, or usual care at improving pain at 3 weeks in people with subacute or chronic neck or back pain (very low-quality evidence). We found no direct information about drug treatments (analgesics, NSAIDs, antidepressants, muscle relaxants, epidural corticosteroids, epidural local anaesthetics) in the treatment of people with acute whiplash injury.
For GRADE evaluation of interventions for neck pain, see table.
We found three systematic reviews (search dates 1993, 2003, and 2006), which identified no RCTs. One subsequent RCT compared a single dose of intramuscular ketorolac versus osteopathic manipulation in 58 people with acute neck pain, 58% of whom had whiplash injuries. However, subgroup analysis for those with whiplash injuries was not reported
The subsequent RCT reported that, with ketorolac, eight people cited one or more of the following: arm soreness, bad taste in mouth, dizziness, drowsiness, dyspepsia, heart racing, light-headedness, nausea, and vomiting. In the manipulation group, one person said their arm felt “funny” after manipulation.
Web publication date: 4 Aug 2008 (based on May 2007 search)