Whiplash Injury Mild, But Frequent
But Some Experts Say Whiplash More Likely To Lead to Disability
March 13, 2003 - Whereas whiplash injury often thought lead to severe disability, a new study suggests pain level is no more than seen with other sprains. But experts question these findings -- and suggest that getting the right treatment early may be key.
In what is believed to be the first study specifically to compare whiplash to another injury, Danish researchers say that the neck injury -- endured by one in five motorists in rear-end collisions, according to the American Academy of Orthopaedic Surgeons -- typically causes mild pain similar to that of ankle sprains. These findings are published in the March issue of Neurology.
"There is a preconceived notion, in general, that whiplash injury is a more severe injury," lead researcher Helge Kasch, MD, PhD, of Aarhus University Hospital in Denmark, tells WebMD. "But our findings show that victims of ankle injuries and whiplash seem similarly disabled by their injuries in the first week."
Interestingly, the 140 whiplash and 40 ankle-injured patients studied reported a similar level of pain in their lower back resulting from their respective injuries. Kasch credits this high frequency among those with ankle sprains to investigators specifically asking about total body symptoms. However, the whiplash patients complained of higher levels of "non-painful" symptoms such as forgetfulness, dizziness, and irritability, and typically took longer to recover.
The two injuries were compared because whiplash is essentially a neck sprain, occurring when the soft tissue of the neck is damaged -- usually as the result of a sudden extension and flexing like that of a rear-end car accident. Whiplash may also injure joints, discs, ligaments, and nerves near the neck, and is typically treated with pain and other medications and a cervical collar for several weeks. Some patients also need physical therapy or are treated with heat.
All of the whiplash patients studied by Kasch were injured in rear-end automobile collisions averaging 25 mph -- although whiplash can result in accidents at much lower speeds. The ankle sprains occurred in various mishaps not related to sports or car accidents. Patients with both injuries were asked to rate their pain levels on a 100-point scale at one week after initial treatment in a hospital emergency room, and again at one, three, six, and 12 months later. Ankle-sprain pain was initially rated an average of 15 (with 100 being the highest), and usually fell to zero within a month. Whiplash patients initially rated their pain at around 20, but it dropped to only 14 after a year. Still, both ratings indicate a low level of pain.
"Acute whiplash injury is a benign condition with high recovery rate, and in general, there is a high frequency of pain but its intensity is low," Kasch tells WebMD. "After one year, 90% of whiplash patients recovered." By comparison, all the ankle-injured had recovered in that time and returned to work.