The rate of recovery following whiplash injury

Abstract

Fifty consecutive patients with soft-tissue neck injuries following rear end collisions were studied prospectively to assess their rate of recovery. Patients were seen within 5 days of the accident, after 3 months, 1 year and 2 years, and their symptoms were classified into one of four groups (A, asymptomatic; B, nuisance; C, intrusive; D, disabling). Fourteen of 15 patients (93%) who were asymptomatic after 3 months remained symptom-free after 2 years. Of 35 patients with symptoms after 3 months, 30 (86%) remained symptomatic after 2 years. After 1 year, 26 (52%) stated that they had recovered completely, but after 2 years this had fallen to 19 (38%). Nine of the 15 patients who had improved between 3 months and 1 year deteriorated to their previous status, or worse, between 1 and 2 years. In asymptomatic cases, a prognosis that is 93% accurate after 2 years can be given after 3 months, and 86% of patients who are symptomatic after 3 months will remain so after 2 years. However, the severity of their symptoms will change during this period and will be at the same degree of severity in less than 50%.

Impact of motor vehicle accidents on neck pain and disability in general practice

“…6,9 The chance of recovery is less favourable for women and decreases with age -14% for every decade according to Harder et al 15 Longer-term (for example, after 5 years) recovery figures are comparable with the figures after 1-year follow-up. 13,16 The majority of patients in these studies reported hardly any change over the years but, if change occurs, deterioration outbalances improvement. Almost all studies available on the prognosis of whiplash are hospital based; 17 thus they are referral based and, therefore, subject to caseselection bias.…”

Whiplash injuries and the potential for mechanical instability

“…This information should help the clinician make more precise diagnoses in the case of whiplash trauma patients. only 38% of the whiplash patients had recovered at their 2-year follow-up [11]. There is a consensus that most whiplash patients suffer soft tissue injuries [8,16,19,20].…”

The Behavioural Response to Whiplash Injury

“…7 A large proportion of patients appears to reach a final state of recovery or chronic symptoms within three months of injury. 5,8,9 The symptoms are often disproportionate to the physical signs 10 and have been shown to correlate poorly with the findings on plain radiographs, 10,11 scintigraphy 12 and MRI. 13 Partly for this reason, the syndrome has been frequently associated with psychological disease.…”