• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of annrheumdAnnals of the Rheumatic DiseasesCurrent TOCInstructions for authors
Ann Rheum Dis. Sep 2005; 64(9): 1337–1342.
Published online Feb 24, 2005. doi:  10.1136/ard.2004.034447
PMCID: PMC1755634

A re-examination of the whiplash associated disorders (WAD) as a systemic illness

Abstract

Objective: To describe the systemic nature of the illness reported after motor vehicle collisions using data from a large, population based cohort of individuals making an injury insurance claim.

Methods: All subjects who submitted a claim or were treated for whiplash injury following a motor vehicle collision in Saskatchewan, Canada during an 18 month period were examined. Demographics of claimants, collision related data, pre-collision health data, symptom prevalence, and scores on the short form 36 item general health survey (SF-36) were obtained on average within one month post-collision.

Results: Of 9006 potentially eligible claimants, 7462 (83%) met criteria for whiplash injury and provided information regarding demographics and injury related symptoms; 45% of these consented to complete the SF-36 at baseline. For most subjects, neck pain was only one of many diffuse and intense symptoms, including, often, low back pain. The range of symptoms, including fatigue, dizziness, paraesthesiae, headache, spinal pain, nausea, and jaw pain, could be interpreted as a systemic disorder. SF-36 scores showed low physical and mental functioning one month post-collision.

Conclusions: What is commonly referred to as whiplash associated disorders (WAD) is best appreciated as a syndrome extending well beyond what can be labelled as a neck injury. More research is needed for a better understanding of the underlying mechanisms involved so that treatment can be directed at the broad spectrum of the illness rather than focusing on finding a focal neck injury.

Full Text

The Full Text of this article is available as a PDF (76K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Spitzer WO, Skovron ML, Salmi LR, Cassidy JD, Duranceau J, Suissa S, Zeiss E. Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining "whiplash" and its management. Spine (Phila Pa 1976) 1995 Apr 15;20(8 Suppl):1S–73S. [PubMed]
  • Hartling L, Brison RJ, Ardern C, Pickett W. Prognostic value of the Quebec Classification of Whiplash-Associated Disorders. Spine (Phila Pa 1976) 2001 Jan 1;26(1):36–41. [PubMed]
  • Holm L, Cassidy JD, Sjögren Y, Nygren A. Impairment and work disability due to whiplash injury following traffic collisions. An analysis of insurance material from the Swedish Road Traffic Injury Commission. Scand J Public Health. 1999 Jun;27(2):116–123. [PubMed]
  • Versteegen GJ, van Es FD, Kingma J, Meijler WJ, ten Duis HJ. Applying the Quebec Task Force criteria as a frame of reference for studies of whiplash injuries. Injury. 2001 Apr;32(3):185–193. [PubMed]
  • Hildingsson C, Toolanen G. Outcome after soft-tissue injury of the cervical spine. A prospective study of 93 car-accident victims. Acta Orthop Scand. 1990 Aug;61(4):357–359. [PubMed]
  • Radanov BP, di Stefano G, Schnidrig A, Ballinari P. Role of psychosocial stress in recovery from common whiplash [see comment]. Lancet. 1991 Sep 21;338(8769):712–715. [PubMed]
  • Cassidy JD, Carroll LJ, Côté P, Lemstra M, Berglund A, Nygren A. Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury. N Engl J Med. 2000 Apr 20;342(16):1179–1186. [PubMed]
  • Côté P, Hogg-Johnson S, Cassidy JD, Carroll L, Frank JW. The association between neck pain intensity, physical functioning, depressive symptomatology and time-to-claim-closure after whiplash. J Clin Epidemiol. 2001 Mar;54(3):275–286. [PubMed]
  • Brekke Mette, Hjortdahl Per, Kvien Tore K. Changes in self-efficacy and health status over 5 years: a longitudinal observational study of 306 patients with rheumatoid arthritis. Arthritis Rheum. 2003 Jun 15;49(3):342–348. [PubMed]
  • Richter M, Krettek C, Otte D, Wiese B, Stalp M, Ernst S, Pape HC. Correlation between crash severity, injury severity, and clinical course in car occupants with thoracic trauma: a technical and medical study. J Trauma. 2001 Jul;51(1):10–16. [PubMed]
  • Mayou R, Bryant B. Outcome in consecutive emergency department attenders following a road traffic accident. Br J Psychiatry. 2001 Dec;179:528–534. [PubMed]
  • Lees-Haley PR, Brown RS. Neuropsychological complaint base rates of 170 personal injury claimants. Arch Clin Neuropsychol. 1993 May;8(3):203–209. [PubMed]
  • Richter M, Ferrari R, Otte D, Kuensebeck H-W, Blauth M, Krettek C. Correlation of clinical findings, collision parameters, and psychological factors in the outcome of whiplash associated disorders. J Neurol Neurosurg Psychiatry. 2004 May;75(5):758–764. [PMC free article] [PubMed]
  • Ferrari R. The biopsychosocial model--a tool for rheumatologists. Baillieres Best Pract Res Clin Rheumatol. 2000 Dec;14(4):787–795. [PubMed]
  • McKinney LA. Early mobilisation and outcome in acute sprains of the neck. BMJ. 1989 Oct 21;299(6706):1006–1008. [PMC free article] [PubMed]
  • Borchgrevink GE, Kaasa A, McDonagh D, Stiles TC, Haraldseth O, Lereim I. Acute treatment of whiplash neck sprain injuries. A randomized trial of treatment during the first 14 days after a car accident. Spine (Phila Pa 1976) 1998 Jan 1;23(1):25–31. [PubMed]
  • Vendrig AA, van Akkerveeken PF, McWhorter KR. Results of a multimodal treatment program for patients with chronic symptoms after a whiplash injury of the neck. Spine (Phila Pa 1976) 2000 Jan 15;25(2):238–244. [PubMed]
  • Rosenfeld M, Gunnarsson R, Borenstein P. Early intervention in whiplash-associated disorders: a comparison of two treatment protocols. Spine (Phila Pa 1976) 2000 Jul 15;25(14):1782–1787. [PubMed]
  • Peeters GG, Verhagen AP, de Bie RA, Oostendorp RA. The efficacy of conservative treatment in patients with whiplash injury: a systematic review of clinical trials. Spine (Phila Pa 1976) 2001 Feb 15;26(4):E64–E73. [PubMed]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Group

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...