Whiplash
The following appear in Ugeskr Laeger. 2010 Jun 14 Articles in Danish
Predictors of chronic sequelae in whiplash trauma. 2010 Jun 14;172(24):1821-1824.
Prognostic factors for chronic whiplash associated disorder are identified. In whiplash associated disorder grade I-III, 50% report neck pain after one year (30% in background population). There is a female preponderance among WAD cases. 10% develop a work disability, but no gender differences are found. Age, crash issues, magnetic resonance imaging of the neck and smooth pursuit neck torsion test are of no prognostic value. While reduced active neck mobility is associated with a 4.6 times raised risk for work disability after one year, the impact-of-event score yielded an increase in OR of 3.3, and intense pre-injury distress was associated with a 2.1 OR for pain after one year and a 2.8 OR for work disability. Intense headache/neck pain and a multitude of non-painful complaints were both associated with a 3.5 to 4.0 times raised risk of work disability after a year.
Treatment of whiplash associated disorders. 2010 Jun 14;172(24):1818-1820.
Treatment of whiplash associated disorders starts with a thorough clinical examination, which may be repeated after 1-3 weeks. For optimal results it is essential that the patient receives clear information about the condition and that any pain is treated effectively with analgesics. Risk factors for persistent symptoms can often be identified early and should be addressed adequately. If symptoms persist and conservative treatments are chosen, these should be active and they should focus on sustaining or regaining usual activities.
Social, economic and cultural aspects of whiplash syndrome. 2010 Jun 14;172(24):1815-1817.
The sequelae following whiplash injuries entail considerable human costs and expenses for both treatment and social services, especially public income benefits. Frequently, many players are involved after whiplash injuries and good intersectional collaboration is therefore essential to counter the whilplash injuries patients’ tendency not to return to their jobs. There is a need for further research i) to identify evidence-based prophylaxis and treatment, ii) to monitor medical diagnoses in relation to social benefits to support research opportunities and iii) to assess whether other social solutions comprise alternatives superior to current treatment and compensation options.
Definition, classification and emidemiology of whiplash. 2010 Jun 14;172(24):1812-1814.
A whiplash trauma is caused by an acceleration-deceleration force transferring its energy to the cervical spine. Whiplash associated disorder refers to the symptoms that develop after a whiplash injury. The prognosis is favorable with recovery in over 90% of the injured subjects. In a fraction of patients, long-term symptoms with pain and cognitive and emotional symptoms may occur, causing long term disability. The pathophysiology is unclear. Most research groups favor a multifactorial pathophysiology similar to that observed for other chronic pain conditions without a clear nociceptive or neuropathic component.
