For many, whiplash recovery is prolonged

In brief

  • Overall, recovery from whiplash and its associated disorders is prolonged. Nearly half of those diagnosed with whiplash-associated disorders reported neck pain symptoms one year after their injury.
  • Recovery is even slower in those whose initial symptoms are more severe.
  • On average, frequent early health-care use is associated with poorer recovery.
  • The best type of health care likely varies from patient to patient and by severity.

Why was this review done?

Many people experience neck pain after a traffic collision. Whiplash is a form of neck injury caused by the force of stopping and starting. Whiplash and its symptoms, which include neck pain and dizziness, are known as whiplash-associated disorders. Evidence and opinions on the expected course of neck pain for whiplash-associated disorders varies. This review synthesizes the best available evidence to help prevent, manage and reduce the burden of whiplash.

How was the review done?

This study is part of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders. Task force members reviewed studies published between 1980 and 2007 on the course of neck pain in whiplash-associated disorders. Studies of fractures or dislocation were excluded, as they were beyond the scope of the task force. In total, 47 high quality studies were included in a best evidence synthesis.

What did the reviewers find?

Nearly half of those diagnosed with whiplash-associated disorders reported neck pain symptoms one year after their injury. Those who reported greater initial pain, disability and more symptoms recovered more slowly. The circumstances of the actual collision, such as direction of the collision, type of headrest or how the head was positioned, were not associated with recovery. However, mental health factors such as depression and a passive coping style were associated with slower recovery.

What are some strengths and weaknesses of the review?

This review is the first to assemble existing information on the course and factors predicting recovery for neck pain in whiplash-associated disorders. The role of compensation and litigation was only examined in two studies, but early evidence suggests they affect prognosis as well.

Publication Information

Title: 

Author(s): 

Carroll L, Holm L, Hogg-Johnson S, Côté P, Cassidy D, Haldeman S, Nordin M, Hurwitz E, Carragee E, van der Velde G, Peloso P, Guzman J

Journal: 

Spine, 2008: vol. 33, no. 4S, pp. S83-S92