The Quebec Task Force on Whiplash Associated Disorders (WAD) redefined “whiplash” in 1995: “Whiplash is an acceleration– deceleration mechanism of energy transfer to the neck which may result from rear-end or side impact, predominantly in motor vehicle collisions, but also from diving accidents, and from other mishaps. The energy transfer may result in bony or soft tissue injuries (whiplash injury), which in turn may lead to a wide variety of clinical manifestations (whiplash-associated disorders).”
The causes of chronic neck pain from motor vehicle accidents are varied and may involve many of the deeper structures in the neck such as the muscles, ligaments, nerves, joints and discs. The difficulty in determining the source of pain relates to the inconsistencies in X-ray and varied clinical findings in patients with pain.
Research studies have found that there is a poor correlation between changes seen on X-rays and the level of pain and disability experienced. Furthermore there are no clinical findings on examination that point to a particular lesion. All this makes it difficult to make a precise diagnosis. This may lead to a lot of confusion for the patient suffering from pain where different therapists give different diagnoses and suggest different treatments. In most cases it is not necessary to make a precise diagnosis initially as in the majority of cases pain settles within the first three months. Manual therapy, traction, adjustments and manipulation have been shown to help in the first few weeks, but for persisting pain a multimodal approach is the most effective addressing all the contributing factors.