Whiplash

An exceptional medical resource for all professions involved in the management of whiplash patients

Whiplash is one of the most debated and controversial musculoskeletal conditions. This is, in part, due to the often compensable nature of whiplash injuries and the fact that a precise pathoanatomical diagnosis is not usually achievable.

Whiplash: Evidence base for clinical practice presents the evidence underpinning the complexity of whiplash associated disorders (WADs).

This ranges from the specifics of current physiological and psychological manifestations of whiplash to broader issues such as compensation and litigation.

This new medical textbook turns the spotlight on whiplash injuries and makes essential reading for anyone involved in the management whiplash patients.

This includes physiotherapy, chiropractic, osteopathy, occupational therapy and health psychology practitioners and postgraduate students, as well as practitioners in rehabilitation therapies and primary care.

• discrete chapters on litigation and the role of compensation in whiplash injuries
• case studies on acute and chronic whiplash conditions
• covers the spectrum of the current evidence base for whiplash
• includes perspectives from a wide range of disciplines
• an invaluable resource for clinicians and policy makers alike

Contributor list

Reviewer list

Preface

Acknowledgments

Introduction

Structure of the book

Chapter 1 Epidemiology of whiplash associated disorders

Definitions

Cumulative incidence of and risk factors for WAD

Course and prognosis of WAD after a motor vehicle crash

An epidemiological approach to aetiology

The economic burden of WAD

Summary

Chapter 2 Clinical presentation of whiplash associated disorders

Patterns of recovery

Physical and psychological characteristics

Classification systems for WAD

Conclusions

Chapter 3 Mechanism of injury

Head–neck kinematics: global and segmental

Injury theories

Injury metrics

Influencing factors for injury potential

Summary

Chapter 4 The evidence for pathoanatomical lesions

Introduction

Pathomechanics of whiplash injury

Pathological lesions in whiplash injury

Conclusion

Chapter 5 Pain-processing mechanisms in whiplash associated disorders

Introduction

Mechanisms for post-injury central hyperexcitability

Evidence for central hyperexcitability in chronic WAD

Evidence for central hyperexcitability in acute WAD and in the transition to chronicity

Relationships between sensory hypersensitivity and psychological distress

Implications for clinical management of whiplash

Conclusion

Chapter 6 Neuromuscular dysfunction in whiplash associated disorders

Changes in the properties of the cervical muscles

Altered neuromuscular control in WAD

Implications for the management of the patient with whiplash

Conclusion

Chapter 7 Dizziness, visual and sensorimotor control disturbances following whiplash injury

Aetiology of dizziness, visual disturbances and sensorimotor control

Disturbances in whiplash associated disorders

Signs and symptoms of sensorimotor disturbance following a whiplash injury

Implications for assessment

Implications for management

Conclusion

Chapter 8 Psychological aspects of whiplash associated disorders

Accident-related psychological factors

Coping

Catastrophising and kinesiophobia

Attributions, beliefs and expectations

Conclusion

Chapter 9 Potential role of stress systems in the pathogenesis of whiplash associated disorders

Sympathetic nervous system

Neuropeptide Y

Serotonin

Clinical implications

Current research needs and future research directions

Chapter 10 Prognostic indicators of non-recovery following whiplash injury

Prognostic factors for non-recovery

Prediction of outcomes other than pain and disability

Clinical implications

Conclusion

Chapter 11 Primary care management of acute whiplash injury

Current evidence for the management of acute WAD

The provision of advice and education

Is pain control important?

Physical characteristics of acute WAD and implications for management

Psychological characteristics of acute WAD and implications for management

Early multidisciplinary management

Summary

Chapter 12 Evidence-based management of chronic whiplash associated disorders

Evidence base for management of chronic whiplash

Evidence for physical interventions

Evidence for psychological interventions

Evidence for medical interventions

Implementation of evidence in clinical practice

Summary

Chapter 13 Psychological management of chronic whiplash associated disorders

Theory-derived psychological interventions

Evidence-based practice

Remaining issues and future prospects

Conclusion

Chapter 14 Compensation and health outcomes

Introduction

Compensation and related concepts

Compensation: empirical considerations

Health: the concept and its measurement

Conclusions

Chapter 15 Whiplash and the law

The test for compensability

Canadian Transport Accident

Compensation

Conclusions

Chapter 16 Malingering and symptom magnification in whiplash

Associated disorders

Why study malingering in the area of whiplash?

What is meant by ‘malingering’?

Approaches to detection of malingering

Differential diagnosis of psychological disorders where symptom production or magnification is a feature

Empirical studies of malingering and symptom magnification in pain

A decision-making template for possible and probable malingering

Chapter 17 Case descriptions

Case description 1: acute whiplash

Case description 2: acute whiplash

Summary of cases 1 and 2

Case description 3: chronic whiplash

Conclusion

Chapter 18 Future directions

Intervention trials

Do some patients have a pre-existing risk of developing chronic pain after whiplash injury?

Improving prognostic models

Identification of a peripheral lesion

Conclusion