Whiplash Injuries

Whiplash injuries have actually gone up since the law requires drivers and passengers to wear seat belts on the road. Whiplash occurs when there is flexion and/or extension of the neck during a motor vehicle accident. A side (lateral) accident, a front-end accident and a rear end accident can do the same thing in causing whiplash accidents.

In a recent study, researchers looked at a non-selected group of patients who suffered a whiplash injury. They looked at the patient history, somatic symptoms, radiological findings, and neuropsychological findings following a car accident in which whiplash occurred. The mechanism of injury was looked at shortly after the injury occurred and patients were followed up over a period of time.

A total of 117 patients who were recently injured due to a car accident and who sustained a whiplash injury were studied. They came from similar sociocultural, economic and educational backgrounds. All had complete coverage of their injuries from a motor vehicle insurance carrier. Patients were seen about a week after their injury and were followed at 3 months, six months, 12 months and 24 months after the accident.

At the time of the accident, the patients had the classic symptoms of whiplash: neck pain, stiffness and relative immobility of the cervical spine along with shoulder and trapezius muscle pain. All had cervical spine films that were negative for fracture or dislocation of the cervical spine. Their neurological examinations were basically normal with no evidence of cervical spinal cord injury or spinal nerve injury. Their cognitive examinations were normal and none had significant psychosocial problems.

At the two year mark, the patients were divided into those who had no significant findings and those who had residual symptoms. These were compared to the initial findings at the time of injury. At two years, 18 percent of all patients still had residual symptoms. Those who were symptomatic were more likely to be older and had a rotated or inclined head position at the time of the crash. The symptomatic patients had a higher incidence of headaches before the accident occurred and had more pain and inflammation at the time of the incident. There were also more signs of arthritic and degenerative changes on x-ray, which was done at the time of the accident. Impaired patients also had a decrease in feelings of well-being as measured at the time of the incident.

Whiplash involves many psychological factors as well as physiological factors. People with increased depression and somatic complaints prior to the time of their accident are more likely to suffer increased pain at the time of the injury and are more likely to have a prolonged course of pain and disability after sustaining a whiplash injury. Such injuries can last several years, depending on the initial state of the injury and the person’s coping mechanisms.