Whiplash (medicine)
Encyclopedia
Whiplash is a non-medical term describing a range of injuries
to the neck
caused by or related to a sudden distortion of the neck associated with extension
. The term "whiplash" is a colloquialism. "Cervical acceleration-deceleration" (CAD) describes the mechanism of the injury, while the term "whiplash associated disorders" (WAD) describes the injury sequelae and symptoms.
Whiplash is commonly associated with motor vehicle accidents
, usually when the vehicle has been hit in the rear; however, the injury can be sustained in many other ways, including falls from stools, bicycle
s or horse
s. It stands out as one of the main injuries covered by the car insurers
. In the United Kingdom
, 430,000 people made a claim for whiplash in 2007 (75% of the UK's motor insurance claims), accounting for 14% of every driver's premium.
Before the invention of cars, whiplash injuries were called “railroad spine” as noted mostly during train collisions. After the invention of cars, the number of whiplash-related injuries have risen sharply due to an increase in rear-end motor vehicle collisions. The first case of severe neck pain arising from a train collision was documented around 1919. Given the wide variety of symptoms that are associated with whiplash injuries the Quebec Task Force on Whiplash-Associated Disorders, coined the phrase, Whiplash-Associated Disorders.
to the shoulders, sensory disturbance (such as pins and needles) to the arms & legs and headaches. Symptoms can appear directly after the injury, but often are not felt until days afterwards. Whiplash is usually confined to the spinal cord, and the most common areas of the spinal cord affected by whiplash are the neck, and the mid-back (middle of the spine).
mechanism that causes whiplash injuries is unknown. A whiplash injury may be the result of impulsive stretching of the spine, mainly the ligament: anterior longitudinal ligament
which is stretched or tears, as the head snaps forward and then back again causing a whiplash injury.
A whiplash injury from an automobile accident is called a cervical acceleration-deceleration injury. Cadaver studies have shown that as an automobile occupant is hit from behind, the forces from the seat back compress the kyphosis of the thoracic spine, which provides an axial load on the lumbar spine and cervical spine. This forces the cervical spine to deform into an S-shape where the lower cervical spine is forced into a kyphosis while the upper cervical spine maintains its lordosis. As the injury progresses, the whole cervical spine is finally hyper-extended.
Whiplash may be caused by any motion similar to a rear-end collision
in a motor vehicle
, such as may take place on a roller coaster
or other rides at an amusement park
, sports injuries such as skiing accidents, other modes of transportation such as airplane travel, or from being hit, kicked or shaken.Shaken baby syndrome
can result in a whiplash injury.
Whiplash associated disorders sometimes includes injury to the cerebrum. In a severe cervical acceleration-deceleration syndrome, a brain injury known as a coup-contra-coup injury occurs. A coup-contra-coup injury occurs as the brain is accelerated into the cranium as the head and neck hyperextend, and is then accelerated into the other side as the head and neck rebound to hyper-flexion or neutral position.
Whiplash symptoms might not always have any pathological (injury) explanation. "Volunteer studies of experimental, low-velocity rear-end collisions have shown a percentage of subjects to report short-lived symptoms", which can not be attributed to any pathogenic effect on the subjects neck.
s to rule out bone fracture
s and may involve the use of medical imaging
to determine if there are other injuries.
s, primarily through the introduction of headrestraints, often called headrest
s. This approach is potentially problematic given the underlying assumption that purely mechanical factors cause whiplash injuries - an unproven theory. So far the injury reducing effects of head restraints appears to have been low, approximately 5-10%, because car seats have become stiffer in order to increase crash-worthiness of cars in high-speed rear-end collisions which in turn could increase the risk of whiplash injury in low-speed rear impact collisions. Improvements in the geometry of car seats through better design and energy absorption could offer additional benefits. Active devices move the body in a crash in order to shift the loads on the car seat.
Below are definitions of different types of head restraints.
Head restraint - refers to a device designed to limit the rearward displacement of an adult occupant’s head in relation to the torso in order to reduce the risk of injury to the cervical vertebrae in the event of a rear impact.
Integrated head restraint or fixed head restraint - refers to a head restraint formed by the upper part of the seat back, or a head restraint that is not height adjustable and cannot be detached from the seat or the vehicle structure except by the use of tools or following the partial or total removal of the seat furnishing”.
Adjustable head restraint – refers to a head restraint that is capable of being positioned to fit the morphology of the seated occupant. The device may permit horizontal displacement, known as tilt adjustment, and/or vertical displacement, known as height adjustment.
Active head restraint – refers to a device designed to automatically improve head restraint position and/or geometry during an impact”.
Automatically adjusting head restraint – refers to a head restraint that automatically adjusts the position of the head restraint when the seat position is adjusted.
A major issue in whiplash prevention is the lack of proper adjustment of the seat safety system by both drivers and passengers. Studies have shown that a well designed and adjusted head restraint could prevent potentially injurious head-neck kinematics in rear-end collisions by limiting the differential movement of the head and torso. The primary function of a head restraint is to minimize the relative rearward movement of the head and neck during rear impact. During a rear-end collision, the presence of an effective head restraint behind the occupant’s head can limit the differential movement of the head and torso. A properly placed head restraint where one can sufficiently protect his/her head lower the chances of head injury by up to 35% during a rear-end collision.,
In contrast to a properly adjusted head restraint, research suggests that there may be an increased risk of neck injuries if the head restraint is incorrectly positioned. More studies by manufacturers and automobile safety organizations are currently undergoing to examine the best ways to reduce head and torso injuries during a rear-end impact with different geometries of the head restraint and seat-back systems.
In most passenger vehicles where manually adjustable head restraints are fitted, proper use requires sufficient knowledge and awareness by occupants. When driving, the height of the head restraint is critical in influencing injury risk. A restraint should be at least as high as the head's center of gravity, or about 9 centimeters (3.5 inches) below the top of the head. The backset, or distance behind the head, should be as small as possible. Backsets of more than 10 centimeters (about 4 inches) have been associated with increased symptoms of neck injury in crashes.
In a sitting position, the minimum height of the restraint should correspond to the top of the driver’s ear or even higher. In addition, there should be minimal distance between the back of head and the point where it first meets the restraint.
Due to low public awareness of the consequence of incorrect positioning of head restraints, some passenger vehicle manufactures have designed and implemented a range of devices into their models to protect their occupants.
Some current systems are:
The Insurance Institute for Highway Safety (IIHS) and other testing centers around the world have been involved in testing the effectiveness of head restraint and seat systems in laboratory conditions to assess their ability to prevent or mitigate whiplash injuries. They have found that over 60% of new motor vehicles on the market have “good” rated head restraints.
To find vehicles with “good rated” head restraints and other safety features please visit the following research-based information sources.
North America
Insurance Institute for Highway Safety
www.whiplashprevention.org
United Kingdom
Thatcham Motor Insurance Repair Research Center
should not be used for longer than 72 hours as it may lead to prolonged inactivity. Return to normal activities of daily living should be encouraged as soon as possible to maximize and expediate full recovery.
A different approach is taken by the National Institute for Neurological Disorders and Stroke, who suggest that treatment for individuals with whiplash may include pain medications, nonsteroidal anti-inflammatory drugs, antidepressants, muscle relaxants, and a cervical collar (usually worn for 2 to 3 weeks). Range of motion exercises, physical therapy, and cervical traction may also be prescribed. Supplemental heat application may relieve muscle tension.
for a few days (which is the case for most people), to severe disability
caused by restricted head movement or of the cervical spine, sometimes with persistent pain
.
Alterations in resting state cerebral blood flow have been demonstrated in patients with chronic pain after whiplash injury.
Injury
-By cause:*Traumatic injury, a body wound or shock produced by sudden physical injury, as from violence or accident*Other injuries from external physical causes, such as radiation injury, burn injury or frostbite*Injury from infection...
to the neck
Neck
The neck is the part of the body, on many terrestrial or secondarily aquatic vertebrates, that distinguishes the head from the torso or trunk. The adjective signifying "of the neck" is cervical .-Boner anatomy: The cervical spine:The cervical portion of the human spine comprises seven boney...
caused by or related to a sudden distortion of the neck associated with extension
Extension (kinesiology)
In kinesiology, extension is a movement of a joint that results in increased angle between two bones or body surfaces at a joint. Extension usually results in straightening of the bones or body surfaces involved. For example, extension is produced by extending the flexed elbow. Straightening of...
. The term "whiplash" is a colloquialism. "Cervical acceleration-deceleration" (CAD) describes the mechanism of the injury, while the term "whiplash associated disorders" (WAD) describes the injury sequelae and symptoms.
Whiplash is commonly associated with motor vehicle accidents
Car accident
A traffic collision, also known as a traffic accident, motor vehicle collision, motor vehicle accident, car accident, automobile accident, Road Traffic Collision or car crash, occurs when a vehicle collides with another vehicle, pedestrian, animal, road debris, or other stationary obstruction,...
, usually when the vehicle has been hit in the rear; however, the injury can be sustained in many other ways, including falls from stools, bicycle
Bicycle
A bicycle, also known as a bike, pushbike or cycle, is a human-powered, pedal-driven, single-track vehicle, having two wheels attached to a frame, one behind the other. A person who rides a bicycle is called a cyclist, or bicyclist....
s or horse
Horse
The horse is one of two extant subspecies of Equus ferus, or the wild horse. It is a single-hooved mammal belonging to the taxonomic family Equidae. The horse has evolved over the past 45 to 55 million years from a small multi-toed creature into the large, single-toed animal of today...
s. It stands out as one of the main injuries covered by the car insurers
Vehicle insurance
Vehicle insurance is insurance purchased for cars, trucks, motorcycles, and other road vehicles. Its primary use is to provide financial protection against physical damage and/or bodily injury resulting from traffic collisions and against liability that could also arise therefrom...
. In the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
, 430,000 people made a claim for whiplash in 2007 (75% of the UK's motor insurance claims), accounting for 14% of every driver's premium.
Before the invention of cars, whiplash injuries were called “railroad spine” as noted mostly during train collisions. After the invention of cars, the number of whiplash-related injuries have risen sharply due to an increase in rear-end motor vehicle collisions. The first case of severe neck pain arising from a train collision was documented around 1919. Given the wide variety of symptoms that are associated with whiplash injuries the Quebec Task Force on Whiplash-Associated Disorders, coined the phrase, Whiplash-Associated Disorders.
Signs and symptoms
Symptoms reported by sufferers include: pain and aching to the neck and back, referred painReferred pain
Referred pain is pain perceived at a location other than the site of the painful stimulus. An example is the case of ischemia brought on by a myocardial infarction , where pain is often felt in the neck, shoulders, and back rather than in the chest, the site of the injury...
to the shoulders, sensory disturbance (such as pins and needles) to the arms & legs and headaches. Symptoms can appear directly after the injury, but often are not felt until days afterwards. Whiplash is usually confined to the spinal cord, and the most common areas of the spinal cord affected by whiplash are the neck, and the mid-back (middle of the spine).
Cause
The exact injuryInjury
-By cause:*Traumatic injury, a body wound or shock produced by sudden physical injury, as from violence or accident*Other injuries from external physical causes, such as radiation injury, burn injury or frostbite*Injury from infection...
mechanism that causes whiplash injuries is unknown. A whiplash injury may be the result of impulsive stretching of the spine, mainly the ligament: anterior longitudinal ligament
Anterior longitudinal ligament
The anterior longitudinal ligament is a ligament that runs down the anterior surface of the spine. It traverses all of the vertebral bodies and intervertebral discs....
which is stretched or tears, as the head snaps forward and then back again causing a whiplash injury.
A whiplash injury from an automobile accident is called a cervical acceleration-deceleration injury. Cadaver studies have shown that as an automobile occupant is hit from behind, the forces from the seat back compress the kyphosis of the thoracic spine, which provides an axial load on the lumbar spine and cervical spine. This forces the cervical spine to deform into an S-shape where the lower cervical spine is forced into a kyphosis while the upper cervical spine maintains its lordosis. As the injury progresses, the whole cervical spine is finally hyper-extended.
Whiplash may be caused by any motion similar to a rear-end collision
Rear-end collision
A rear-end collision is a traffic accident wherein a vehicle crashes into the vehicle in front of it, usually caused by tailgating or panic stops...
in a motor vehicle
Motor vehicle
A motor vehicle or road vehicle is a self-propelled wheeled vehicle that does not operate on rails, such as trains or trolleys. The vehicle propulsion is provided by an engine or motor, usually by an internal combustion engine, or an electric motor, or some combination of the two, such as hybrid...
, such as may take place on a roller coaster
Roller coaster
The roller coaster is a popular amusement ride developed for amusement parks and modern theme parks. LaMarcus Adna Thompson patented the first coasters on January 20, 1885...
or other rides at an amusement park
Amusement park
thumb|Cinderella Castle in [[Magic Kingdom]], [[Disney World]]Amusement and theme parks are terms for a group of entertainment attractions and rides and other events in a location for the enjoyment of large numbers of people...
, sports injuries such as skiing accidents, other modes of transportation such as airplane travel, or from being hit, kicked or shaken.Shaken baby syndrome
Shaken baby syndrome
Shaken baby syndrome is a triad of medical symptoms: subdural hematoma, retinal hemorrhage, and brain swelling from which doctors, consistent with current medical understanding, infer child abuse caused by intentional shaking...
can result in a whiplash injury.
Whiplash associated disorders sometimes includes injury to the cerebrum. In a severe cervical acceleration-deceleration syndrome, a brain injury known as a coup-contra-coup injury occurs. A coup-contra-coup injury occurs as the brain is accelerated into the cranium as the head and neck hyperextend, and is then accelerated into the other side as the head and neck rebound to hyper-flexion or neutral position.
Whiplash symptoms might not always have any pathological (injury) explanation. "Volunteer studies of experimental, low-velocity rear-end collisions have shown a percentage of subjects to report short-lived symptoms", which can not be attributed to any pathogenic effect on the subjects neck.
Diagnosis
Diagnosis occurs through a patient history, head and neck examination, X-rayX-ray
X-radiation is a form of electromagnetic radiation. X-rays have a wavelength in the range of 0.01 to 10 nanometers, corresponding to frequencies in the range 30 petahertz to 30 exahertz and energies in the range 120 eV to 120 keV. They are shorter in wavelength than UV rays and longer than gamma...
s to rule out bone fracture
Bone fracture
A bone fracture is a medical condition in which there is a break in the continuity of the bone...
s and may involve the use of medical imaging
Medical imaging
Medical imaging is the technique and process used to create images of the human body for clinical purposes or medical science...
to determine if there are other injuries.
Québec Task Force
The Québec Task Force (QTF) has divided whiplash-associated disorders into five grades.- Grade 0: no neck pain, stiffness, or any physical signs are noticed
- Grade 1: neck complaints of pain, stiffness or tenderness only but no physical signs are noted by the examining physician.
- Grade 2: neck complaints and the examining physician finds decreased range of motion and point tenderness in the neck.
- Grade 3: neck complaints plus neurological signs such as decreased deep tendon reflexes, weakness and sensory deficits.
- Grade 4: neck complaints and fracture or dislocation, or injury to the spinal cord.
Prevention
The focus of preventive measures to date has been on the design of car seatCar seat
A car seat is the chair used in automobiles. Most car seats are made from inexpensive but durable material in order to withstand as much use as possible.-Ergonomy: Lumbar and thigh support:...
s, primarily through the introduction of headrestraints, often called headrest
Headrest
In an automobile, head restraints are attached or integrated into the top of the seats in each seating position to limit the rearward movement of an adult occupant's head relative to his torso in a crash, so as to reduce the danger of whiplash or other injury to the cervical vertebrae...
s. This approach is potentially problematic given the underlying assumption that purely mechanical factors cause whiplash injuries - an unproven theory. So far the injury reducing effects of head restraints appears to have been low, approximately 5-10%, because car seats have become stiffer in order to increase crash-worthiness of cars in high-speed rear-end collisions which in turn could increase the risk of whiplash injury in low-speed rear impact collisions. Improvements in the geometry of car seats through better design and energy absorption could offer additional benefits. Active devices move the body in a crash in order to shift the loads on the car seat.
Occupant Dynamics during a rear-end collision
In order to understand what causes whiplash injuries, it is useful to take a look at how your vehicle seat and your body interact during a rear-end collision. Below you can see in slow motion the way your body moves when your vehicle gets hit from behind. While the time associated with a specific collision will vary, the following provides an example of the occupant and seat interaction sequence for a collision lasting approximately 300 milliseconds.| 0 Milliseconds • Rear car structure is impacted and begins to move forward and/or crushes • Occupant remains stationary • No occupant forces |
100 Milliseconds • Vehicle seat accelerates and pushes into occupant’s torso (i.e. central portion of the body in contact with seat) • The torso loads the seat and is accelerated forward (seat will deflect rearward) • Head remains stationary due to inertia |
150 Milliseconds • Torso is accelerated by the vehicle seat and may start to ramp up the seat • Lower neck is pulled forward by the accelerated torso/seat • The head rotates and extends rapidly rearward hyper-extending the neck |
| 175 Milliseconds • Head is still moving backwards • Vehicle seat begins to spring forward • The torso continues to be accelerated forward • The head rotation rearward is increased and is fully extended. |
300 Milliseconds • Head and torso are accelerated forward • Neck is “whipped” forward rotating and hyper-flexing the neck forward • The head accelerates due to neck motion and moves ahead of the seat back |
Whiplash Prevention
For the last 40 years, vehicle safety researchers have been designing and gathering information on the ability of head restraints to mitigate injuries resulting from rear-end collisions. As a result, different types of head restraints have been developed by various manufactures to protect their occupants from whiplash.Below are definitions of different types of head restraints.
Head restraint - refers to a device designed to limit the rearward displacement of an adult occupant’s head in relation to the torso in order to reduce the risk of injury to the cervical vertebrae in the event of a rear impact.
Integrated head restraint or fixed head restraint - refers to a head restraint formed by the upper part of the seat back, or a head restraint that is not height adjustable and cannot be detached from the seat or the vehicle structure except by the use of tools or following the partial or total removal of the seat furnishing”.
Adjustable head restraint – refers to a head restraint that is capable of being positioned to fit the morphology of the seated occupant. The device may permit horizontal displacement, known as tilt adjustment, and/or vertical displacement, known as height adjustment.
Active head restraint – refers to a device designed to automatically improve head restraint position and/or geometry during an impact”.
Automatically adjusting head restraint – refers to a head restraint that automatically adjusts the position of the head restraint when the seat position is adjusted.
A major issue in whiplash prevention is the lack of proper adjustment of the seat safety system by both drivers and passengers. Studies have shown that a well designed and adjusted head restraint could prevent potentially injurious head-neck kinematics in rear-end collisions by limiting the differential movement of the head and torso. The primary function of a head restraint is to minimize the relative rearward movement of the head and neck during rear impact. During a rear-end collision, the presence of an effective head restraint behind the occupant’s head can limit the differential movement of the head and torso. A properly placed head restraint where one can sufficiently protect his/her head lower the chances of head injury by up to 35% during a rear-end collision.,
In contrast to a properly adjusted head restraint, research suggests that there may be an increased risk of neck injuries if the head restraint is incorrectly positioned. More studies by manufacturers and automobile safety organizations are currently undergoing to examine the best ways to reduce head and torso injuries during a rear-end impact with different geometries of the head restraint and seat-back systems.
In most passenger vehicles where manually adjustable head restraints are fitted, proper use requires sufficient knowledge and awareness by occupants. When driving, the height of the head restraint is critical in influencing injury risk. A restraint should be at least as high as the head's center of gravity, or about 9 centimeters (3.5 inches) below the top of the head. The backset, or distance behind the head, should be as small as possible. Backsets of more than 10 centimeters (about 4 inches) have been associated with increased symptoms of neck injury in crashes.
In a sitting position, the minimum height of the restraint should correspond to the top of the driver’s ear or even higher. In addition, there should be minimal distance between the back of head and the point where it first meets the restraint.
Due to low public awareness of the consequence of incorrect positioning of head restraints, some passenger vehicle manufactures have designed and implemented a range of devices into their models to protect their occupants.
Some current systems are:
- Mercedes-BenzMercedes-BenzMercedes-Benz is a German manufacturer of automobiles, buses, coaches, and trucks. Mercedes-Benz is a division of its parent company, Daimler AG...
A-ClassMercedes-Benz A-ClassThe Mercedes-Benz A-Class is a mini MPV produced by the German automobile manufacturer Mercedes-Benz. The first generation was introduced in 1997, and the all-new second generation model appeared in late 2004. Launched as a five-door hatchback in 1997, the second generation W169 introduced a...
Active Head Restraint (AHR), - SaabSaab AutomobileSaab Automobile AB, better known as Saab , is a Swedish car manufacturer owned by Dutch automobile manufacturer Swedish Automobile NV, formerly Spyker Cars NV. It is the exclusive automobile Royal Warrant holder as appointed by the King of Sweden...
(Responsible for the first active head restraint), OpelOpelAdam Opel AG, generally shortened to Opel, is a German automobile company founded by Adam Opel in 1862. Opel has been building automobiles since 1899, and became an Aktiengesellschaft in 1929...
, Ford, Nissan, SubaruSubaru; is the automobile manufacturing division of Japanese transportation conglomerate Fuji Heavy Industries .Subaru is internationally known for their use of the boxer engine layout popularized in cars by the Volkswagen Beetle and Porsche 911, in most of their vehicles above 1500 cc as well as...
, HyundaiHyundaiHyundai ) is a global conglomerate company, part of the Korean chaebol, that was founded in South Korea by one of the most famous businessmen in Korean history: Chung Ju-yung...
, and PeugeotPeugeotPeugeot is a major French car brand, part of PSA Peugeot Citroën, the second largest carmaker based in Europe.The family business that precedes the current Peugeot company was founded in 1810, and manufactured coffee mills and bicycles. On 20 November 1858, Emile Peugeot applied for the lion...
- Active Head restraint (SAHR), - VolvoVolvo CarsVolvo Car Corporation, or Volvo Personvagnar AB, is a Swedish automobile manufacturer founded in 1927, in Gothenburg, Sweden. It is owned by Zhejiang Geely Holding Group. Volvo was originally formed as a subsidiary company to the ball bearing maker SKF. When Volvo AB was introduced on the Swedish...
and JaguarJaguar (car)Jaguar Cars Ltd, known simply as Jaguar , is a British luxury car manufacturer, headquartered in Whitley, Coventry, England. It is part of the Jaguar Land Rover business, a subsidiary of the Indian company Tata Motors....
- Whiplash Protection System/Whiplash Prevention System (WHIPSWHIPSWHIPS, or Whiplash Protection System, is a system of protection against automotive whiplash injuries introduced by Volvo in 1999 in the Volvo S80....
), and - Toyota - Whiplash Injury Lessening (WIL).
The Insurance Institute for Highway Safety (IIHS) and other testing centers around the world have been involved in testing the effectiveness of head restraint and seat systems in laboratory conditions to assess their ability to prevent or mitigate whiplash injuries. They have found that over 60% of new motor vehicles on the market have “good” rated head restraints.
To find vehicles with “good rated” head restraints and other safety features please visit the following research-based information sources.
North America
Insurance Institute for Highway Safety
www.whiplashprevention.org
United Kingdom
Thatcham Motor Insurance Repair Research Center
Treatment
According to the recommendations made by the Quebec Task Force, treatment for individuals with whiplash associated disorders grade 1-3 should include manipulation, mobilizations and range of motion exercises. Non-narcotic analgesics and non-steroidal anti-inflammatory drugs may also be prescribed in the case of WAD 2 and WAD 3, but their use should be limited to a maximum of 3 weeks. A cervical collarCervical collar
A cervical collar is an orthopedic medical device used to support a patient's neck and head. It is also used by emergency personnel for victims of traumatic head or neck injuries, and can be used to treat chronic medical conditions....
should not be used for longer than 72 hours as it may lead to prolonged inactivity. Return to normal activities of daily living should be encouraged as soon as possible to maximize and expediate full recovery.
A different approach is taken by the National Institute for Neurological Disorders and Stroke, who suggest that treatment for individuals with whiplash may include pain medications, nonsteroidal anti-inflammatory drugs, antidepressants, muscle relaxants, and a cervical collar (usually worn for 2 to 3 weeks). Range of motion exercises, physical therapy, and cervical traction may also be prescribed. Supplemental heat application may relieve muscle tension.
Prognosis
The consequences of whiplash range from mild painPain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
for a few days (which is the case for most people), to severe disability
Disability
A disability may be physical, cognitive, mental, sensory, emotional, developmental or some combination of these.Many people would rather be referred to as a person with a disability instead of handicapped...
caused by restricted head movement or of the cervical spine, sometimes with persistent pain
Chronic pain
Chronic pain has several different meanings in medicine. Traditionally, the distinction between acute and chronic pain has relied upon an arbitrary interval of time from onset; the two most commonly used markers being 3 months and 6 months since the initiation of pain, though some theorists and...
.
Alterations in resting state cerebral blood flow have been demonstrated in patients with chronic pain after whiplash injury.
External links
- University of Queensland - Whiplash Evidence Based Information Resource
- Centre of Clinical Research Excellence in Spinal Pain, Injury and Health (CCRE Spine) Current Studies http://uq.edu.au/ccre-spine/current-studies