Whiplash: diagnosis, treatment, an associated injuries. Curr Rev Musculoskelet Med

Department of Neurological Surgery, Thomas Jefferson University Hospital, 909 Walnut Street, 3rd Floor, Philadelphia, PA 19107, USA.
Current Reviews in Musculoskeletal Medicine 04/2008; 1(1):65-8. DOI: 10.1007/s12178-007-9008-x
Source: PubMed


Focused review of the current literature.
To identify and synthesize the most current data pertaining to the diagnosis and treatment of whiplash and whiplash-associated disorders (WAD), and to report on whiplash-related injuries.
A search of OVID Medline (1996-January 2007) and the Cochrane database of systematic reviews was performed using the keywords whiplash and WAD. Articles under subheadings for pathology, diagnosis, treatment, and epidemiology were chosen for review after identification by the authors.
A total of 485 articles in the English language literature were identified. Thirty-six articles pertained to the diagnosis, treatment, epidemiology of whiplash, and WAD, and were eligible for focused review. From these, 21 primary and 15 secondary sources were identified for full review. In addition, five articles were found that focused on whiplash associated cervical injuries. These five articles were also primary sources.
Whiplash is a common injury associated most often with motor vehicle accidents. It may present with a variety of clinical manifestations, collectively termed WAD. Whiplash is an important cause of chronic disability. Many controversies exist regarding the diagnosis and treatment of whiplash injuries. The multifactorial etiology, believed to underly whiplash injuries, make management highly variable between patients. Radiographic evidence of injury often cannot be identified in the acute phase. Recent studies suggest early mobilization may lead to improved outcomes. Ligamentous and bony injuries may go undetected at initial presentation leading to delayed diagnosis and inappropriate therapies.

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Available from: James S Harrop, Oct 06, 2015
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    • "Health care expenses and productivity loss from persistent post-MVC pain cost an estimated $29 billion per year in the United States alone [16] [20]. The development of effective interventions to prevent persistent pain after MVC and the advancement of understanding to guide these interventions remain important international research priorities [29] [58]. "
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    ABSTRACT: Persistent musculoskeletal pain is common after motor vehicle collision (MVC) and often results in substantial disability. The objective of this study was to identify distributions of post-MVC pain which most interfere with specific life functions and which have the greatest interference with aggregate life function. Study data were obtained from a prospective longitudinal multicenter emergency department-based cohort of 948 European Americans experiencing MVC. Overall pain (0-10 numeric rating scale (NRS)), pain in each of 20 body regions (0-10 NRS), and pain interference (Brief Pain Inventory, 0-10 NRS) were assessed 6 weeks, 6 months, and 1 year after MVC. After adjustment for overall pain intensity, an axial distribution of pain caused the greatest interference with most specific life functions (R(2) = 0.15-0.28, association p-values <.001) and with overall function. Axial pain explained more than twice as much variance in pain interference as other pain distributions. However, not all patients with axial pain had neck pain. Moderate or severe low back pain was as common as neck pain at week 6 (prevalence 37% for each) and overlapped with neck pain in only 23% of patients. Further, pain across all body regions accounted for nearly twice as much of the variance in pain interference as neck pain alone (60% vs. 34%). These findings suggest that studies of post-MVC pain should not focus on neck pain alone.
    Pain 06/2014; DOI:10.1016/j.pain.2014.06.013 · 5.21 Impact Factor
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    Medicinski pregled 01/2011; 64(1-2):5-9.
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