Early aggressive care delays recovery after whiplash, study confirms

In brief

  • Too much health care too early after a whiplash injury has a negative affect on a patient's recovery.
  • Combining chiropractic and general physician care appears to have no benefit.
  • Researchers successfully reproduced the results of an earlier study and confirmed that the findings were not due to chance.

Why was this study done?

Chiropractors, general practitioners or physiotherapists may all treat whiplash injuries. Recent research suggests that intensive care early in the recovery period from whiplash can actually prolong the injury. This means that the type and intensity of care following a whiplash injury can affect a patient’s recovery in the long-term. This study aimed to replicate these findings.

How was the study done?

Researchers looked at the clinical care of 1,693 Saskatchewan adults who sustained whiplash injuries in 1994. They identified eight patterns of care during the first month after the injury. The patterns were based on the number of visits (low or high) and the type of care provider (general practitioners, chiropractors and specialists). After taking into account such factors as the severity of the injury, researchers then calculated recovery times for patients in each of the eight patterns.

What did the researchers find?

In general, aggressive and early care was associated with slower recovery rates. Specifically, recovery was slower in cases where patients had:

  • more than two visits with a general practitioner (GP) compared to one or two visits
  • more than six visits with a chiropractor compared to less than six visits, or
  • care from both a chiropractor and a general practitioner.

Patients who made the fewest visits to a general practitioner recovered the fastest. In contrast, those who made the most visits to a general practitioner and who also sought care from a chiropractor had the slowest recovery of all groups.

What are some strengths and weaknesses of the study?

Though researchers controlled for factors such as injury severity, there may have been other factors, such as coping, which may have influenced the results. The study benefits from the accuracy of the information on clinical care experiences, which was drawn from Saskatchewan Health, the province's ministry of health.

Publication Information

Title: 

Early aggressive care and delayed recovery from whiplash: Isolated finding or reproducible result?

Author(s): 

Côté P, Hogg-Johnson S, Cassidy D, Carroll L, Frank J, Bombardier C

Journal: 

Arthritis & Rheumatism, 2007: vol. 57, no. 5, pp. 861-868