Whiplash – “Will This Ever Get Better?”
Whiplash (or WAD – whiplash associated disorders) can be defined by a sudden movement of the head and neck beyond its normal range of motion resulting in pain and stiffness and less often, numbness and tingling in the arms and hands. Prognosis is a term associated with a predicted outcome of a condition with the passage of time, either with or without treatment. A condition is considered “stable” when symptoms aren’t changing and are not likely to change significantly over the next several months to a year. In general, recovery may depend on the severity of the injury. Usually, minor whiplash injuries will resolve completely within approximately one to two weeks, moderate whiplash injuries within approximately four to eight weeks, and severe whiplash may or may not completely “resolve.” Rather, severe whiplash may result in a chronic condition which may lead to a permanent reduction or a complete loss of certain functions. There are “risk factors” that can result in either a prolonged recovery or just a partial recovery, regardless of the degree of injury which makes the process of prognosing whiplash cases challenging. Let’s take a closer look!
There have been many published studies that have looked at the long-term prognosis of whiplash injuries using different approaches. For example, one study reported that reduced cervical range of motion was able to predict those less likely to fully recover after one year.
Another study broke down acute whiplash patients into seven risk levels using one-year work disability (total number of days missed from work) as the main outcome measure. The age of injured subjects ranged from 18-70 years and injuries varied between WAD 1 to 3 (WAD 1 = Pain but no loss of motion, primarily soreness; WAD 2: Loss of motion and muscle tightness/pain; WAD 3: Same as WAD 2 but WITH neurological problems like numbness &/or weakness in the arms due to nerve injury). The study evaluated a total of 483 women and 250 men within ten days of their motor vehicle collision (MVC). At the end of one year, a total of 605 participants completed the study and were given a “RISK SCORE” which included: a) initial neck pain/headache intensity; b) the number of non-painful complaints; and c) active cervical range of motion. When researchers compared the patients’ RISK SCORE at the one-year mark to their work disability (number of sick days), they found a direct correlation between lower scores and lower work disability and higher scores and greater work disability. They concluded that this could be a valuable tool to assess a patient’s ability to return to work following WAD injuries.
It’s worth noting that many studies have found no association between the amount of damage to the vehicle and the patient’s risk for a poor outcome.
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