Whiplash – A New Integrated Model

Whiplash injury is caused by a rapid and sudden movement to the neck and in turn it may lead to a variety of clinical manifestations called Whiplash-Associated Disorders (WAD). It can result from many mechanisms such as diving into a swimming pool, being in a fight or falling however the most common preceding factor is a car crash.

It is estimated that about 20% to 50% of patients who sustain a symptomatic whiplash injury go on to report chronic and persistent pain. Neck pain is probably the best example of a medical condition where there is a disconnect between the magnitude of injury and the magnitude of disability as well as economic cost, particularly those resulting from a car accident.

Many different models and explanations have been proposed to help improve outcomes for people with WAD and to try and reduce the cost burden on the economy, but to date there has been a lack of clarity and unity between such tools. Current concepts include the fear avoidance model, the diathesis-stress model as well as classification systems such as the Quebec Task Force Classification (QTF) and the hunt for a specific pathoanatomical lesion, a particular structure which is the source of the chronic pain, goes on.

As with all of models, regardless of topic, they each have their own strengths and weaknesses and there is concern that current concepts have become outdated and lack the incorporation of biopschyosocial concepts. James Elliot and David Walton have done something about this. They have created a new integrated model of WAD. They hope will bring future WAD research towards a more inter-disciplinary focus to allow policy makers, patients and healthcare professionals to work together to improve patient and consumer outcomes. The model has recently been published in the Journal of Orthopedic & Sports Physical Therapy.

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To learn more about the latest evidence, assessment and treatment of common neck conditions, like WAD, keep your eyes peeled for our neck course which is coming soon.

Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.

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