Whiplash Injuries
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Pain in Rheumatology (W Nielson and M Harth, Section Editors)
Whiplash Injuries Robert Teasell, MD FRCPC1,2,* Swati Mehta, PhD3 Eldon Loh, MD FRCPC4 Address 1 Department of Physical Medicine and Rehabilitation, Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada *,2 Lawson Research Institute and Parkwood Institute, St. Joseph’s Health Center London, Parkwood Institute Main, 550 Wellington Rd, London, Ontario, N6A 0A7, Canada Email: [email protected] 3 Lawson Health Research Institute, London, Ontario, Canada 4 Department of Physical Medicine and Rehabilitation, Schulich School of Medicine, University of Western Ontario, St. Joseph’s Health Center London, London, Ontario, Canada
* Springer Nature Switzerland AG 2020
This article is part of the Topical Collection on Pain in Rheumatology Keywords Whiplash I Facet joints I Pain I Exercise I Education I Psychology
Abstract Purpose of review Whiplash injuries, also known as whiplash-associated disorders, are commonly seen after motor vehicle accidents and are challenging to manage as a large number of individuals go on to chronicity and are resistant or only partially responsive to current treatments. Recent findings Although the pathophysiology remains uncertain, there is compelling evidence that a significant number of chronic whiplash injuries are associated with involvement of the cervical facet joints, C2-3 and C5-6 being the most often identified as the cause of pain. The diagnosis of whiplash remains a clinical diagnosis as radiological techniques have not been able to consistently identify the pathological basis of the pain. The clinical syndrome of whiplash/WAD includes neck pain or stiffness, arm pain and paresthesias, temporomandibular dysfunction, headache, visual disturbances, memory and concentration problems, and psychological distress. Education and exercise programs appear to be the most strongly supported interventions, although many questions remain about the relative effectiveness of various exercise protocols and their long-term impact. Psychological treatment is important for those clearly not coping well. For those patients who do not respond to conventional treatments, radiofrequency neurotomy may be a potential treatment option. Summary Despite its frequency and high rates of disabling symptoms, our understanding and treatment of whiplash injuries has shown little progress over the past two decades.
Pain in Rheumatology (W Nielson and M Harth, Section Editors)
Introduction Whiplash injuries, also known as whiplash-associated disorders (WAD), have been referred to as a cervical acceleration-deceleration injury. The term whiplash was attributed to Crowe in 1928, and before that, in the nineteenth century, these types of injuries were recognized following railway accidents, the so-called railway spine. Beginning in the 1950s, there was an increase in persistent neck injuries following motor vehicle accidents, which led to mandatory head rests in the 1960s. The diagnosis has been controversial bec
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