Overview of whiplash-associated disorder

Carroll, 2008Hincapie, 2010Holm, 2007Kamper, 2008

Whiplash-associated disorder refers to nonspecific neck pain caused by an acceleration–deceleration force to the neck, usually from a motor vehicle collision. In whiplash-associated disorder, most symptom improvement occurs in the first 3 months and then symptoms plateau; about 50% of patients still experience some symptoms at 6 to 12 months. The main prognostic factor for whiplash-associated disorder is the severity of initial symptoms, including sensory, motor and psychological components (trauma). Evidence indicates that features of an acceleration–deceleration event, such as direction of impact, seating position, awareness of impending collision, and being stationary when hit, have no effect on outcome.

Most patients who present in primary care with whiplash-associated disorder will not require imaging for assessment unless a serious pathology is suspected clinically. For detailed advice on when to do imaging for patients with a suspected cervical spine injury, see The Canadian C-Spine Rule.