Correlation Between Whiplash-Associated Disorders & Long Term Effects

A 2009 study found that patients with whiplash-associated disorders can continue to experience symptoms for as long as ten years after the original injury producing event.[1]  The study only looked at patients with such injuries and symptoms ten years out, and thus did not determine how much longer into the future the subjects might continue to experience symptoms beyond ten years.

The study included 133 patients (63 men, 70 women) who received acute whiplash injuries from a motor vehicle collision between 1993 and 1996.  The study reported that there were no significant differences in age, sex, or symptoms, including the presence of or severity of neck pain, between the participants and the nonparticipants at the time of the injury.  All participants had undergone neurological examinations by spine surgeons and MRIs after the initial injury producing event.

The study revealed that while most patients reported significant improvements in their symptoms and pain levels after ten years, a number of participants continued to experience symptoms.  Interestingly, of those who reported:

• Neck pain after the collision, 22.2% of those participants reported either unchanged (11.2%) or exacerbated (12.0%) neck pain in the follow-up study;
• Shoulder stiffness after the collision, 43.2% of them reported unchanged (30.9%) or exacerbated (12.3%) shoulder stiffness; and
•  Pain or numbness following the collision, 31.6% of participants reported some form of upper extremity pain and 29.4% reported some level of upper extremity numbness in the follow-up study.[2]

On physical examination:

• 15% of participants still had neck tenderness;
• 15.9% still had pain on motion;
• 17.9% still had restricted range of motion;
• 12.5% still had a positive Spurling test; and
• 14.3% still had reduced muscle strength.[3]

The study also revealed that 28.6% of women in the study had an unfavorable prognosis[4] for neck pain compared to 17.5% of men.  “Double collisions” (rear-end impacts followed by a front end impact), had a 54.5% unfavorable prognosis for neck pain, compared to only 25% for front-end collisions and 20.5% for rear-end collisions.[5]

Concerning shoulder stiffness: an unfavorable prognosis for  58.6% of women, compared to 38.1% of men.  Double collisions were more likely to produce an unfavorable prognosis for shoulder stiffness (72.7%), with front-end collisions second (60.7%) and rear-end collisions third (38.4%).[6]

For upper extremity pain or numbness, women were only slightly more likely than men to have an unfavorable prognosis (22.9% to 17.5%).  Double collisions were responsible for 45.5% of the unfavorable prognosis for upper extremity numbness, followed by front-end collisions (25%) and rear-end collisions (16.4%).[7]

This study confirms that whiplash associated disorders can have long lasting or chronic implications for many patients and could be useful in providing a basis for understanding that not all patients recover fully from whiplash associated disorders.  Though studies are useful to provide a basis for establishing that musculoskeletal injuries result in chronic residuals, explaining why it occurs is of critical importance in a traumatic injury case both for the healthcare professional who is establishing the basis of ongoing treatment needs and for the patient who can be potentially left with long term residuals.

The attorneys at Adler Giersch, PS are committed to helping those patients struggling with long term residuals from a traumatic injury.  We know that injuries can have a profound short term and long term impact to one’s daily activities at work, home and recreational pursuits – and we can prove it.