Whiplash is MORE Than Just Neck Pain

When car accident victims are examined post-collision, many clinicians look to the neck since it is a commonly affected body part in cases of whiplash.  What often happens, though, is the clinician gets fixated on that part of the body and does not carefully look elsewhere.  This is why “eliciting” a patient history as opposed to “taking” one is critical.   In a recent article written by Hincapié, Cassidy, Côté, Carroll and Guzmán (2010), the authors sought to review the secondary pain patterns in accident victims.  This study was a “cross-sectional analysis of a population-based cohort of 6481…residents…” (p. 434).

The authors reported the pain complaints as follows, “Irrespective of pain in other areas, 86% of respondents reported posterior neck pain, 72% indicated head pain, and 60% noted lumbar back pain. Ninety-five percent of claimants reported some pain within the posterior trunk region, comprising the posterior neck, shoulder, mid-back, lumbar, and buttock areas.

Only 0.4% of respondents reported posterior neck pain only.

Four main patterns accounted for 60% of the variance in pain localization: 1) upper anterior trunk and upper extremity pain; 2) head, posterior neck, and upper posterior trunk pain; 3) low back pain; and 4) lower anterior trunk and lower extremity pain” (Hincapié et al., 2010, p. 434).

This is further evidence of the complexity of presenting complaints post motor vehicle accident.  Clinicians must be aware of these patterns when assessing bodily injury in order to accurately document causation.    Finally, the authors stated, “To the best of our knowledge, it is the first study in the literature to focus on the descriptive epidemiology of pain location after traffic injury. The vast majority of persons involved in MVCs have neck pain; however, this is but one area of pain localization that most commonly involves multiple areas of the body” (Hincapié et al., 2010, p. 438).

References:

Hincapié, C. A., Cassidy, J. D., Côté, P., Carroll, L. J., & Guzmán, J. (2010). Whiplash injury is more than neck pain: A population-based study of pain localization after traffic injury. Journal of Occupational and Environmental Medicine,52(4), 434-440.