Talk:Whiplash (medicine)

Biomechanical aspects

Could someone please address this person's nonsense? "Probably the best known...injuries nowadays." Um, how bout the bruise? This section is way too hard for a layperson to penetrate and methinks quite a bit unnecessary. "How can this be diagnosed then?" is not an appropriate title and is better off in the diagnosis subhead. The whole thing could be dissected, reparceled and redistributed to the rest of the article. Thanks. Sideburnstate 21:11, 14 August 2007 (UTC)

Reliably diagnosing this disorder is difficult, since it is based on the subjective reports of the patient, who must answer questions about pain in movement by the doctor. No clear standard exist to diagnose whiplash, and doctors may resort to using standard tables listing the possible range of motion of the human head. If a patient cannot achieve the full motion, it is probable that the reason is pain or injury caused by the whiplash.

I think this article fails to differentiate between (typically short-term) physical injury, and the long-term (controversial, and possibly psychological) condition that was so common a few years ago. I should also address the controversy, I think. kzm 12:13, 6 November 2007 (UTC)

Higher severity cases are easily visible even in X-Rays.

A rising percentage of car accidents result in a refund claim based on whiplash. This is partly due to an increased awareness, but it is likely that the difficulty excluding the diagnosis makes it easy to raise false claims.

Personal injury claims and awards as a whole have been going down, contrary to what insurance companies say.

I also think this article should be further expanded. I personally suffer from "Grade 4" (3 vertebrae dislocated in 2 separate directions) from being rear-ended. I was dismayed when I looked it up on Wikipedia a year after the accident just out of curiosity and found what I heard from a claims adjuster (who made a generous offer of $250 for my partially-disabling and very painful injury). —Preceding unsigned comment added by 67.77.74.72 (talk • contribs) 06:57, 7 May 2005

Is there a connection with whips? —Preceding unsigned comment added by 82.131.245.27 (talk • contribs) 23:08, 2 July 2005

I just replaced that section that defines the definiton a little less "Quebec-based" but I can't find any less Quebec-related information, unfortunetely. --Dmacdonald95 20:16, 9 July 2006 (UTC)

QTF section should be tempered with not only an explanation of what the grades mean, but some of the controversy surrounding them. Such as: Initially created by AC Croft (Croft Guidelines) several years before Spitzer published his QTF paper. The guidelines were also changed during that event which introduced some rather glaring errors. Since the QTF paper is such an often quoted paper for whiplash (virtually every other paper touching the subject cites it in the references) its errors should be exposed.

e.g. #1: (from: Freeman, M.D., et al., A review and methodologic critique of the literature refuting whiplash syndrome. Spine, 1999. 24(1): p. 86-96.) "The Results and Discussion section of the case series study contained numerous references to the percentage of the study population "recovered" at the time of cessation of compensation. However, the QTF did not gather any data regarding the symptoms, amount or type of treatment, or functional impairment of its cohort-all factors necessary to determine the level of recovery after an injury. The QTF chose to define "recovery" unconventionally as cessation of time-loss compensation."

e.g. #2: Unsupported Conclusions. In a table entitled "Prevalence of Symptoms at Follow-Up," the QTF enumerated the four studies on prognosis that were accepted for review, along with its findings. Ref 1: 66% of their cohort had neck pain 2 years after injury. Ref 2: reported 27% were symptomatic 6 months after the MVC, and 27% of their cohort had headaches 6 months after the MVC. Ref 3: reported 44% were symptomatic at an average of 2 years after the MVC.

Somehow the QTF concluded that "Whiplash associated disorders are usually self-limited," and "Patients should be reassured that most WAD are benign and self-limiting," inaccurately summarizing the results of its literature review and case-series study.Drwagnerdc (talk) 06:50, 10 February 2008 (UTC)

Even mild rear end collisions can result in whiplash and be seen on x-ray as a loss of cervical lordosis. This can be a straightening of the neck or an s-curve shape that will over several years time result in arthritic changes to the mid cervical spine. This is why the condition of Whiplash is a major cause of permenant impairment in the world.

This straightening and s-curve shape has been observed on cadavers and human volunteer rear impact crash tests on numerous peer reviewed papers. (see Yogananden, University of Wisconson Medical School, Wisconson, USA ) Further, these studies demonstrate the damage to the cervical ( neck )facet joints.

Relief of the pain involves returning the neck to some degree of cervical lordosis either through spinal realignments via manipulations or cervical lordosis building traction. —Preceding unsigned comment added by 67.83.42.12 (talk • contribs) 18:52, 5 July 2005

Authors to reference- Harrison, Don, Grauer, Kaneoka K, Matshushita T, Yang K and Begeman P of Wayne State University, Detroit, Michigan,USA, Malanga G ,and Dellanno R, Croft A, Kleinberger M ( Johns Hopkins Univ.APL). —Preceding unsigned comment added by 67.83.42.12 (talk • contribs) 19:22, 5 July 2005

The name probably refers to the whip-like motion of the head and neck seen during a rear-end. Tronno — Preceding undated comment added 13:53, 24 August 2005

Ok, how do any of these complaints have to do with the neutrality of this article?? - M0r3Educ@tedth@nY0u —Preceding unsigned comment added by 68.112.4.176 (talk • contribs) 02:54, 4 May 2006

They don't. Whiplash is a real disease and a diagnosis given by reputable doctors. It is not as the writer indicates a term prefered by lawyers. That is what prevents this article from being neutral. —Preceding unsigned comment added by Spowers (talk • contribs) 19:40, 26 May 2006

Worldview template

I added this because the article seems overly focused on Quebec. Quebec is not the only place where whiplash occurs, and it would be nice to see how its regarded in the rest of the world (or even the rest of Canada or North America for that matter). It certianly needs more about the medical side of things, and maybe an X-ray image if someone can aquire one without copyright and patient privacy issues. ONUnicorn 14:16, 16 June 2006 (UTC)

Cause

Whiplash is caused when the anterior longitudinal ligament of the spine tears or is stretched.—Preceding unsigned comment added by 137.222.10.67 (talk • contribs)

The above is just a theory!

Whiplash like symptoms reported after placebo rear end collision

I have added the findings of Castro et al, because I think it is important to also show that some research, especially by law firms has been done in this field, as whiplash in low stages is hard to diagnose and sometimes no pathological reason can be found. —Preceding unsigned comment added by 80.199.51.230 (talk) 13:23, 13 January 2009 (UTC)

Possible copyright violation

This page has some of the same text as the article. Not sure who copied who. Edward 12:32, 7 April 2007 (UTC)

NB: page referred to above no longer available as of 9 December 2013 — Preceding unsigned comment added by 2002:560E:7483:0:A871:5A23:9EF4:4ACB (talk) 11:28, 9 December 2013 (UTC)

New sections

The sections added by User:Hkiessecker (here) really don't belong in my mind - there are no sources, they seem to criticize the medical establishment pretty strongly considering there are no sources, there seems to be some original research or assumptions happening, the tone is all wrong, and I find it virtually incomprehensible from a purely english perspective. The links added are all to some sort of whiplash wiki, which are barred by the external links policy. Any other thoughts? WLU 19:35, 20 September 2007 (UTC)

Endorse removal per WP:V, WP:NPOV, WP:RS, WP:NOR, WP:SOAP, WP:SPAM, WP:COI, WP:EL, and any other policy that I am missing. Leuko 19:40, 20 September 2007 (UTC)

Just to be kosher (not in the literal sense), points were brought up with User:Jfdwolff and User:Arcadian. WLU 19:43, 20 September 2007 (UTC)

Whiplash_(medicine)#Protection

Does the Protection section seem like an ill-conceived attempt to advertise to anyone else? WLU (t) (c) Wikipedia's rules:^simple/_complex 01:17, 15 September 2009 (UTC)= Existing Talk Page Title =

Fact and Citation Check

(Part of the WikiProject Medicine effort)

Background section:

• Citation needed for “Whiplash is commonly associated with motor vehicle accidents”. I suggest the following reference, Clinical Application of Neuromuscular Techniques: The Upper Body, By Leon Chaitow, Judith DeLany, page 261: http://books.google.com/books?id=H6yOM8uYYZkC&pg=PA261&dq=whiplash+horse&cd=10#v=onepage&q=whiplash%20horse&f=false
• Possible replacement reference for the “when vehicle has been hit in the rear” statement: The whiplash encyclopedia: the facts and myths of whiplash By Robert Ferrari, page 43. http://books.google.com/booksid=yZpMi0ktOVoC&printsec=frontcover&dq=facts+and+myths+of+whiplash&cd=1#v=onepage&q=rear&f=false

For “bicycles and horses”

• If you change the sentence to be more of a summary, then cite http://www.nlm.nih.gov/medlineplus/ency/article/000025.htm could be used instead
  
• If “bicycles and horses” must stay, this could be used: Clinical Application of Neuromuscular Techniques: The Upper Body By Leon Chaitow, Judith DeLany, Edition 2, 2008, page 262. http://books.google.com/books?id=H6yOM8uYYZkC&pg=PA261&dq=whiplash+horse&cd=10#v=onepage&q=whiplash%20horse&f=false
  • Page 261 actually mentions falls from bikes, horses.

The “car insurers” phrase could use a cite.

• I suggest the British auto insurer report that is the basis for the BBC story cite (could be used in conjunction with BBC story). http://www.abi.org.uk/Media/Releases/2008/11/ABI_reveals_whiplash_epidemic.aspx
  
• The citation after “accounting for 14% of every driver’s premium” is good for the first half of this same sentence. However, I cannot find this particular statistic in the reference, and I am also unable to provide another reference for that statistic. There are many references out there about the cost to each driver. For example, I suggest changing this phrase to say “account for £66 of each driver’s insurance premium” because this is found within the BBC story.
• The fragment " (75% of the UK's motor insurance claims)" has been removed as it is factually incorrect and not supported by the citation. — Preceding unsigned comment added by 93.97.23.247 (talk) 20:16, 22 March 2012 (UTC)

Signs and Symptoms section:

The only Current Cite is not in English.

• I added the section tag instead of putting citation needed after all three sentences.<br /
• This might be a good reference: Orthopedic massage: theory and technique, By Whitney Lowe, 2003, page 160. Orthopedic massage: theory and technique. http://books.google.com/booksid=fmaxqMk2VpUC&pg=PA160&dq=whiplash+symptoms+include&cd=2#v=onepage&q=whiplash%20symptoms%20include&f=false
• Also see refs suggested in Background section

Cause section:

Current Cite http://www.nlm.nih.gov/medlineplus/ency/article/000025.htm only covers “forward and back” and would be better as a citation in the initial summary section (see “bicycles and horses” note in previous section).

• Suggested reference for mechanism: Intervertebral disk diseases: causes, diagnosis, treatment and prophylaxis By Jürgen Krämer, 2008 edition, page 346. http://books.google.com/books?id=4eXxdL0ouTAC&dq=whiplash+roller+coaster&q=prognosis#v=snippet&q=prognosis&f=false
  • This is an excellent reference summarizing the definition, epidemiology, mechanism of injury, treatment, and prognosis for whiplash.
• Also, The whiplash encyclopedia: the facts and myths of whiplash, by Robert Ferrari, page 468. Reviews accelerations and forces in the three axes. http://books.google.com/books?id=yZpMi0ktOVoC&pg=PA217&dq=Whiplash+hit+in+rear&lr=&as_drrb_is=q&as_minm_is=0&as_miny_is=&as_maxm_is=0&as_maxy_is=&as_brr=0&cd=1#v=onepage&q=Whiplash%20hit%20in%20rear&f=false
  • This is also a good ref for factors that may affect whiplash prognosis and it is good for other info.

Current Cite http://www.spinalinjuryfoundation.org/research%20PDF/rollercoasterneckpain.pdf suggests a pdf that is not accessible.

• For “anterior longitudinal ligament “, I suggest adding another citation to the end of the sentence that includes this phrase. I suggest Frontiers in head and neck trauma: clinical and biomechanical By Narayan Yoganandan, page 313: http://books.google.com/books?id=f-vML_ZQWsIC&pg=PA313&dq=anterior+longitudinal+ligament+whiplash&cd=8#v=onepage&q=anterior%20longitudinal%20ligament%20whiplash&f=false
• For eiteology (including roller coaster and sports injuries), you can ref. Intervertebral disk diseases: causes, diagnosis, treatment and prophylaxis By Jürgen Krämer. The 1990 version (Ed. 2), page 92: http://books.google.com/books?id=oFyDvjls8tsC&pg=PA92&dq=whiplash+roller+coaster&cd=3#v=onepage&q=whiplash%20roller%20coaster&f=false

Current Cite http://www.montazem.de/english/html/whiplash_injury.html is an MD’s personal website. Not a sufficient citation?

• Current Cite http://www.nlm.nih.gov/medlineplus/ency/article/000025.htm could be used here, but might require slight modification of the sentence (just say sports injuries instead of being specific).
• For shaken baby syndrome – you could use something new in place of Current Cite – here is another NIH site http://www.nlm.nih.gov/medlineplus/ency/article/000004.htm
• Here is something on “whiplash shaken baby syndrome” from the American Academy of Pediatrics http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/1/206

Current Cite http://www.ncbi.nlm.nih.gov/pubmed/11508796 is a commentary on a 2002 article in Int J Legal Med; maybe too primary? —The linked abstract from 2001 is a study, not a commentary. There were commentaries in 2002 regarding this article.80.71.135.37 (talk) 07:04, 18 January 2011 (UTC)

• Here is a textbook with a comment: Clinical Application of Neuromuscular Techniques: The Upper Body By Leon Chaitow, Judith DeLany, Edition 2, 2008, page 262: http://books.google.com/books?id=H6yOM8uYYZkC&pg=PA261&dq=whiplash+horse&cd=10#v=onepage&q=whiplash%20horse&f=false

Other refs…

• Frontiers in whiplash trauma: clinical and biomechanical By Narayan Yoganandan, Frank A. Pintar http://books.google.com/books?id=Zm1PavZOmaIC&pg=PA163&dq=whiplash+kramer&cd=1#v=onepage&q=whiplash%20kramer&f=false
• For factors that may affect whiplash prognosis and other info see: Motor vehicle collision injuries: biomechanics, diagnosis, and management By Larry S. Nordhoff (this book is directed toward clinicians) http://books.google.com/books?id=vSGyTBzHuUkC&pg=PA274&dq=Whiplash+is+commonly+associated+with+motor+vehicle+accidents&lr=&as_brr=0&cd=7#v=onepage&q=whiplash&f=false
  

Diagnosis section:

• When I attempt to view the reference for the Quebec Task Force document, I get a permission error and cannot view the file. I suggest the following reference: The whiplash encyclopedia: the facts and myths of whiplash By Robert Ferrari, page 3 at the following link: http://books.google.com/books?id=D4Sl9FqKUwMC&pg=PA3&dq=quebec+task+force+whiplash+grades&cd=2#v=onepage&q=quebec%20task%20force%20whiplash%20grades&f=false

Prevention section:

• The section on car seats and head restraints has a reference that is a dead link that is also in a different language. I suggest the following references for this section:
• http://books.google.com/books?id=Zm1PavZOmaIC&pg=PA467&dq=whiplash+car+seat+prevent&cd=2#v=onepage&q=whiplash%20car%20seat%20prevent&f=false Frontiers in whiplash trauma: clinical and biomechanical, By Narayan Yoganandan, Frank A. Pintar, page 467:
• http://books.google.com/books?id=83n5xNHgywQC&pg=PA426&dq=whiplash+headrest+prevent&cd=3#v=onepage&q=whiplash%20headrest%20prevent&f=false Neurology and trauma, By Randolph W. Evans on page 426:
• The section on “whiplash prevention devices” would benefit from the following citation, as most in this section are out of date or are dead links. http://www-nrd.nhtsa.dot.gov/pdf/esv/esv20/07-0468-O.pdf

The Swedish National Road Administration story is a link in a different language. However, it has a button on the left toolbar that allows it to be easily switched over into English, so I think this citation is good. Also, the citation in the last sentence of this section links to an article to which not everyone will have access. However, the abstract, which is open access, is enough for this citation to be of value.

Treatment section:

The citation after the paragraph about the recommendations made by the Quebec Task Force for the treatment of whiplash is a good one, but not everyone will have access. I suggest Frontiers in whiplash trauma: clinical and biomechanical By Narayan Yoganandan, Frank A. Pintar, page 555: http://books.google.com/books?id=Zm1PavZOmaIC&pg=PA557&dq=quebec+task+force+whiplash+treatment&cd=1#v=onepage&q=quebec%20task%20force%20whiplash%20treatment&f=false

Prognosis section:

• I suggest adding another reference after this sentence “The consequences of whiplash range from mild pain for a few days (which is the case for most people)[19], to severe disability caused by restricted head movement or of the cervical spine, sometimes withpersistent pain.” I suggest the following reference: The headaches By Jes Olesen, page 880: http://books.google.com/books?id=VXMI1ry9FgQC&pg=PA880&dq=whiplash+pain+restricted+movement&cd=1#v=onepage&q=whiplash%20pain%20restricted%20movement&f=false
• For the cerebral blood flow sentence, I suggest adding another reference that is open access, such as Foundations for integrative musculoskeletal medicine: an east-west approach, By Alon Marcus, Michael Kuchera, page 619: http://books.google.com/books?id=WbThUt45ZXgC&pg=PA619&dq=whiplash+alterations+cerebral+blood+flow&cd=10#v=onepage&q=whiplash%20alterations%20cerebral%20blood%20flow&f=false

• I hope that these sources will be of assistance in the efforts to improve this wiki. Best wishes! FactCheck EH (talk) 01:53, 7 May 2010 (UTC)

Metallica

Yeah...... —Preceding unsigned comment added by 70.138.142.68 (talk) 02:27, 16 November 2010 (UTC)

I agree wholeheartedly!! Maelstromlusby (talk) 18:31, 2 August 2011 (UTC)

Fraudulent injury.

Perhaps a section on the possibility that many whiplash injuries are in fact due to a confluence of a semi-fraudulent personal injury law industry and suggestibility/nocebo effect in minor road traffic accident victims. Sorry about pay-wall. http://www.thetimes.co.uk/tto/opinion/columnists/article3401701.ece

Great suggestion. There is a lot of sources which suggest whiplash fraud is a major problem among auto insurers. — Preceding unsigned comment added by 209.16.113.3 (talk) 19:25, 6 August 2013 (UTC)

COnsidering this has become a greatly debated legal issue in the uk I also think a section should be added about this.Peachywink (talk) 04:58, 12 February 2016 (UTC)

70 years of study funded mainly by the auto insurance industry

70 years of study mostly funded by the auto insurance industry, with the requirement the any diagnosis or treatment must be cost effective, why is anyone surprised its still a mystery, meanwhile the insurers enjoy record profits and talk up fraud, while they have been avoiding paying or caring properly for victims. 2403:580C:1E83:0:3807:49E:5FA0:6913 (talk) 16:53, 15 March 2024 (UTC)