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What is Whiplash?

What is whiplash?

Whiplash is a relatively common injury that occurs to a person's neck following a sudden acceleration-deceleration force, most commonly from motor vehicle accidents. The term "whiplash" was first used in 1928. The term "railway spine" was used to describe a similar condition that was common in persons involved in train accidents prior to 1928. The term "whiplash injury" describes damage to both the bone structures and soft tissues, while "whiplash associated disorders" describes a more severe and chronic condition.

Fortunately, whiplash is typically not a life threatening injury, but it can lead to a prolonged period of partial disability. There are significant economic expenses related to whiplash that can reach 30 billion dollars a year in the United States, including:  medical care, disability, sick leave, lost productivity, and litigation.

While most people involved in minor motor vehicle accidents recover quickly without any chronic symptoms, some continue to experience symptoms for years after the injury. This wide variation in symptoms after relatively minor injuries has led some to suggest that, in many cases, whiplash is not so much a real physiologic injury, but that symptoms are more created as a result of potential economic gain. Many clinical studies have investigated this issue. Unfortunately, while there will always be people willing to attempt to mislead the system for personal gain, nevertheless, whiplash is a real condition with real symptoms.

How often does this happen?

To explain how often something happens, we use the term incidence. This is usually reported as the number of cases occurring each year per 100,000 persons in the population. Although the incidence of 1 million whiplash injuries per year is often quoted, this originated with an outdated and incomplete 1971 dataset. More recently, it has been estimated by Croft that as many as 3 million such injuries occur in the U.S. each year. This figure is expected to be the best currently available because it is based on several government databases and accounts for the expected degree of underreporting reported by NHTSA.

How many people suffer from whiplash?

How prevalent is this problem, or in other words, how many people suffer from this condition at any given time? Self-limiting diseases can have high incidences and low prevalence's. Chronic (incurable) diseases will always have higher prevalence than incidence. For example, during the summer months, the prevalence of the common cold may be low, even though the incidence for the year was high because many people had a cold in the early spring. But every new case of an incurable disease adds to both incidence and prevalence, although the incidence can be low in a disease with high prevalence. (Diabetes, while treatable, is an example of a disease that is incurable.)

In the case of whiplash we attempt to find out how many people who are at risk-which includes just about anyone who travels by car--has chronic neck pain due to whiplash. Research at the Spine Research Institute of San Diego indicates the number is probably as high as 10%. More interestingly, perhaps, is the finding that as much as 45% of persons with chronic neck pain attribute the pain to a past Motor Vehicle Crash (MVC) injury. It is clear that motor vehicle crashes profoundly diminish the nation's health and welfare: this is a scary fact and statistic considering that most MVC's are potentially preventable.

Potential Risk

Risk Factors

In discussing risk, researchers ask the question: what proportion of the population who is exposed to the putative agent of the disease-in the case of whiplash the agent would be an MVC-actually develops the disease. In very rough terms, in a LOSRIC in the range of 4-10 mph delta V, from an analysis of a fairly large international literature, the risk hovers around 33%. It is higher for rear impact collisions, lower for frontal collisions and intermediate for side impact collisions. Of course, individual risk factors and crash parameters must always be considered. Moreover, the severity of these injuries varies widely, with the more minor not always requiring formal treatment.

Who is more at risk?

Women are at nearly twice the likelihood of suffering from whiplash injury than men. Most indications point to body mass and structural density being the reason. In other words, men tend to have larger upper body and neck musculature than women. Putting women at greater risk.

Complicating Factors

• Awareness: those unaware more likely to be hurt.
• Gender; females almost twice as likely to be hurt.
• Age: may or may not come into play.
• Head rotation/body position.
• Taller persons at greater risk.
• Severity.
• Past episodes.
• Duration (how long the problem has been there).
• Radicular symptoms (is there numbness, tingling in arms or legs, do they fall asleep).
• DJD Degenerative Joint Disease. If there is degeneration/arthritis in the joints.
• Organic Disease
• Delayed treatment
• Deconditioning of the muscles and soft tissues.
• Instability