is a term used to describe a variety of symptoms that can occur following a whiplash injury, commonly associated with rear-end vehicle collisions. Symptoms may include neck pain, headaches, dizziness, and cognitive difficulties.
Factors affecting injury severity in whiplash:
Gender: May influence the risk and severity of symptoms due to physiological differences.
Awareness
Age
Head restraint position
Impact velocity
Seat or occupant positioning
Pain is prevalent in nearly all patients, often accompanied by neck stiffness.
Neck pain found in 92% of referred patients (Radinov et al, 1995).
Headaches reported in 50-90% of patients (Sterling, 2011).
Shoulder and arm pain experienced by 40-70% of patients (Sterling, 2011).
Thoracic and lumbar back pain reported in 35% of patients (Sterling, 2011).
Paraesthesia/Anaesthesia (primarily in upper limbs) reported by 20% of patients (Sterling, 2011).
Balance and postural changes
Unsteadiness and clumsiness
Dizziness
Visual disturbances
Auditory disturbances (e.g., tinnitus)
Temporomandibular joint pain
Photophobia
Fatigue
Cognitive difficulties: loss of concentration and memory impairment.
Possible link to underlying brain injury as cause is still unclear.
Grade 0: No neck pain or physical signs.
Grade I: Muscle tightness, Neck pain, stiffness, tenderness; no physical signs.
Grade II: Strain, Neck pain with musculoskeletal signs such as decreased range of motion or tenderness.
Grade III: Disc injury, neck pain with neurological signs including reflex changes, muscle weakness, sensory deficits.
Grade IV: Neck pain with fracture or dislocation.
Symptoms may include:
Anxiety
Post-Traumatic Stress Symptoms (PTSD) (Dunne-Proctor, 2015)
Study findings:
40% of whiplash patients demonstrate psychological resilience.
43% have moderate PTSD symptoms initially, with 17% experiencing persistent moderate symptoms for over 12 months (McCarthy S.).
Symptoms can manifest immediately or be delayed by 12-15 hours (Sterling, 2011).
50% of individuals may experience ongoing symptoms and not fully recover within one year post-injury (Sterling, 2011).
Evidence shows limited improvement for symptoms persisting beyond three months (Kamper et al, 2008).
Chronic WAD symptoms may include sensitivity to cold and are often associated with poor prognosis (Marcuzzi et al, 2015).
Common cervical dysfunctions involve:
Increased cervical tone, including myofascial trigger points (Nijs et al, 2009).
Impaired cervical movement control (various studies).
Note: Improvements in cervical function do not guarantee enhancement in overall patient health status, which complicates care.
Various factors linked to WAD include:
Sensorimotor disturbances (Treleaven, 2008)
Augmented central nociceptive processing (Jull Sterling et al, 2011)
Stress system responses and PTSD (Jull Sterling et al, 2011)
Psychosocial and sociocultural factors (Jull Sterling et al, 2011)
The role of compensation in WAD recovery is debated in literature.
Evidence suggests that mild traumatic brain injury may contribute to WAD (Findling et al, 2011; Cassidy et al, 2014; Hartvigsen et al, 2014).