Whiplash and Long-Term Outcome

This study examined the injury mechanisms and somatic, radiologic, and psychosocial variables in 117 whiplash patients for a follow-up period of two years.

The percentage of patients with residual pain was similar to that found in other studies: 44% had pain at 3 months, 30% at 6 months, 24% at 12 months, and 18% at 2 years. Only 4% of the patients were considered disabled at two years.

A large number of variables were taken into consideration, to determine which played a role in the long-term outcome of whiplash. The only factors found to play a significant role were:

• Inclined or rotated head position at the time of collision. These patients were more likely to have pain at 2 year follow-up.
• A history of pre-traumatic headache predicted worse outcome.
• Patients with long-term symptoms were more likely to have radicular symptoms, anxiety, sleep disturbance, blurred vision, "symptoms of cranial nerve or brainstem dysfunction," and signs of osteoarthrosis of the spine. These patients were also more likely to report more pain immediately after the accident.

Other important points made in this study:

"Our results suggest that the significance of psychosocial factors in determining recovery from whiplash has been overestimated due to excessive focusing on these factors retrospectively in highly selected samples of patients."

"...the present findings support the view that poor outcome in the long term after whiplash injury (that is, late whiplash syndrome) is primarily related to the initial severity of the injury."

This study is an important addition to the whiplash literature because, first, the patients in this study were unselected - that is, 117 patients were studied immediately after their accidents and followed for two years - and, secondly, the study was conducted in Switzerland, where the legal system allows reimbursement for medical expenses, but not for pain and suffering, eliminating the bias of compensation seeking behavior.

Radanov BP, Sturzenegger M, Di Stefano G. Long-term outcome after whiplash injury. A two-year follow-up considering the features of injury mechanisms and somatic, radiologic, and psychosocial findings. Medicine September 1995 74(5):281-296.

 

 

Home | Combining Therapies | Meet the Specialists | Treatment
Free Consultation | Cost and Time | Car Accident | Location | Contact Us