Whiplash Continues Its Challenge

Abstract

There have been many advances in the management of neck pain disorders, but a personal frustration as a clinician and researcher in the field is that the incidence of full recovery following a whiplash injury as a result of a motor vehicle crash has not increased and, subsequently, the rate of transition to chronic neck pain has not lessened. The commentaries in this special issue reflect the multifaceted nature of whiplash-associated disorders and the wide-ranging research in the field. While management of whiplash, especially the challenge of lessening the rate of transition to chronicity, has yet to be achieved, the picture is becoming clearer. This should give great confidence and some hope to individuals with whiplash-associated disorders who have long-term pain and functional disability that after the next decade of research and clinical development, the outcomes following whiplash are likely to be vastly improved. J Orthop Sports Phys Ther 2016;46(10):815-817. doi:10.2519/jospt.2016.0112.

Changes in Pain Sensitivity and Conditioned Pain Modulation During Recovery From Whiplash-associated Disorders

“…Of those diagnosed with WAD, up to 55% may still experience symptoms such as neck pain and stiffness, dizziness, and/or sleep problems several years after the incident (3)(4)(5)(6). However, despite significant advances in the understanding and management of WAD, there seems to be no reduction in the proportion of people developing persistent symptoms (7).…”

Muscle fat infiltration following whiplash: A computed tomography and magnetic resonance imaging comparison

“…[9] The subsequent multifactorial clinical presentations, which are commonly referred to as whiplash-associated disorders (WAD), [10] include, but are not limited to, neck-related disability, [11] sensorimotor disturbances, [12] distress, [13] and neck muscle degeneration and weakness. [14][15][16][17] The personal, public, and socioeconomic burdens of WAD are complex [18] with inconsistent scientific explanations [19] and a lack of strong evidence to mitigate the persistent pain, disability, and loss of function for the millions affected worldwide. [20] Those injured and experiencing persistent pain, disability, and loss of function may benefit if findings from advanced diagnostic imaging studies were identified, related to the clinical signs and symptoms, and able to inform a plan of care.…”

Soft-collar use in rehabilitation of whiplash-associated disorders - A systematic review and meta-analysis

“…As such, identifying optimal and cost-effective treatment strategies for WAD is a priority among both researchers, health care professionals and funders (Galasko et al, 2002;Pink et al, 2016). However, despite advances in our knowledge of WAD, the number of injured people who develop persistent symptoms is not declining (Carroll et al, 2008;Jull, 2016b;Rasmussen et al, 2020). Interestingly, studies investigating the effect of a comprehensive guideline based treatment approach compared to a single session of advice (Lamb et al, 2013) or usual care (Jull et al, 2013) have shown no between-group differences.…”