There are many factors and symptoms associated with whiplash injury with neck pain being the most common.
Whiplash and whiplash associated disorders describe a range of neck injuries related to sudden disorders of the neck in rear-end crashes. The most common symptom reported after whiplash injury is neck muscle strain or tearing of soft tissues which include muscles and ligaments. According to the Insurance Research Council, 2003, Neck sprain or strain is the most serious injury reported in more than 33% of automobile injury insurance claims, with back sprain or strain accounting for another 20%.
Neck PainFactors influencing neck injury risk to occupants of whiplash collisions include gender, seating position and design. Women are more likely to sustain neck injuries than men. Front seat occupants, especially drivers are more likely to sustain neck injuries than rear seat occupants. Seats with poor headrest design and placement allow an occupant's head to whip back and forth during a rear impact are more likely to experience neck injuries.
According to Traffic Injury Prevention, 9:561-567, 2008, Effective head restraints help to limit the whipping motion responsible for damage to the neck. Driver neck injury rates were 15% lower for vehicles with good ratings as compared to poor. Importantly, driver neck injuries lasting 3 months or more were 35% lower for vehicles with seat/head restraints rated good than for those rated as poor. The authors state, "The majority of neck sprain symptoms clear up within a month, but some can last for years." Relating importance, they additionally relate, "Preventing these long term injuries should be a high priority". They further note, "Encouraging automakers to design seats that earn good safety ratings should greatly lessen the problem of whiplash injuires".
Preventing chronic neck pain (lasting 3 months or more) is essential. High pain intensity in the neck and head, signs and symptoms of radiating pain (radicular signs/symptoms), older age, female gender, and tort insurance systems are associated with delayed recovery in whiplash neck injuries as indicated in Spine Journal 26: E445–E458, 2001. Additionally, studies also indicate that psychological and psychosocial factors such as general psychological distress, early depressive symptoms, passive coping strategies, and perceived helplessness are also associated with poor prognosis in whiplash.
Whiplash Injury To Neck
The Spine Journal, 2006 Feb 15;31(4):E98-104 noted, fair or poor health before the collision was associated with severe neck pain in females along with low education and prior neck pain. The article further states, low family income was associated with severe neck pain in males, as was prior headache and being unaware of the head position at the time of collision. In the Public Library of Science article; PLoS Med 5(5): e105, they noted the following factors which complicate whiplash recovery; gender, age, education, family status, general health prior to injury including prior neck pain and headache, prior injuries, memory loss after the injury, number of pain areas, severity of eight pain-associated symptoms, pain intensity in the neck, head, low back and other body parts, anxiety and depression, post traumatic stress symptoms and passive coping strategies.
Whiplash Neck PainAccording to the Results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders, "The preponderance of evidence indicates that, in adults, recovery of WAD [whiplash associated disorders] is prolonged, with approximately half of those affected reporting neck pain symptoms 1 year after the injury." Their inquiry indicated, "Most studies examining recovery from WAD in adult populations suggest a prolonged recovery." Initial pain levels and symptoms are directly related to persistance of neck pain symptoms. The Task Force indicated, "Symptom reporting was greater among those who presented with neck pain accompanied by neurologic signs (equivalent to WAD III): 90% of these patients reported being symptomatic a year after their injury."
Further investigation by the Task Force inciated, "At 7 years post injury, almost 40% of those making a claim for traffic-related WAD reported often or always having neck pain, compared with less than 15% of a matched cohort who had been in a car crash with no WAD. This latter figure is consistent with the prevalence of 'frequent' neck pain or neck pain which 'interferes with activities' in the general population. Persons with a history of WAD were also more likely to have pain in other parts of their body and to report general ill health, sleep disturbance, and fatigue at 7 years post injury. Furthermore, 30 months after the injury, 7% of WAD patients seen in emergency departments in Umea, Sweden, were still on sick leave; and 5% of WAD patients seen in emergency departments in Norway were on rehabilitation or permanent disability pension."
The Québec Classification of Whiplash Associated Disorders (WAD) is a clinical classification system which grades symptoms as follows:
* Grade 0 WAD refers to no neck complaints and no physical signs.
* Grade I WAD refers to injuries involving complaints of neck pain, stiffness or tenderness, but no physical signs.
* Grade II WAD refers to neck complaints accompanied by decreased range of motion and point tenderness (musculoskeletal signs).
* Grade III WAD refers to neck complaints accompanied by neurologic signs such as decreased or absent deep tendon reflexes, weakness and/or sensory deficits.
* Grade IV WAD refers to injuries in which neck complaints are accompanied by fracture or dislocation.
* Other symptoms related to whiplash besides neck pain; deafness, dizziness, tinnitus, headache, memory loss, dysphagia, and temporomandibular joint pain can be present in all grades.
In the Journal of Rheumatology. 2007 Jan;34(1):193-200, the authors indicate those with whiplash injury who report early depressive symptoms and more severe neck injury symptoms are at risk of developing wide spread pain (9 or more painful areas).