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Think whiplash is only a physical injury? Think again...

Whiplash is commonly regarded as a post-traumatic condition initiated by distortion and sprain in the neck as a result of trauma. Tissue injury is thought to be the cause of acute symptoms and, if symptoms persist, the central nervous system becomes sensitised resulting in a lowering of pain thresholds.

Interestingly, in those that suffer whiplash injury, accumulative cases have shown a number of negative MRI studies where tissue injury has previously been assumed. Patients were further questioned about specific details about the initial incident, the initial clinical presentation, and later chronicity. 78% of patients observed noted they did not have forewarning of the initial trauma, suggesting stimulation of the fight or fight response. Low back pain may also develop as a result of a whiplash injury which highlights that whiplash injury is not specific to the neck region. Symptoms tend to evolve over a period of hours to days after the initial incident, leading to muscular pain and tenderness, and impacted neuromotor control of neck muscles, as well as adjacent muscle groups. These symptoms seem to fit an evolving central neurological disorder rather than a tissue injury response.

The muscular tenderness may exist as a result of dysfunctional neuromuscular innervation, including both hyperactivity and abnormal activation patterns. The concept that a central nervous system disorder may be the causative pathology of whiplash symptoms rather than tissue injury is a new paradigm for further research to take place. This research should widen therapist approaches and thinking to offer the most appropriate care for patients with whiplash injury.

Astruo, J. and Gyntelberg, F. (2022). The Whiplash Disease Reconsidered. Front.Neuro. 821097.


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