The notion of a “whiplash culture”: a review of the evidence

Abstract

There are many unanswered questions about the basis of chronic whiplash, and the notion of a whiplash culture is controversial. Chronic whiplash symptoms are surely not caused entirely by cultural issues, yet they are probably not entirely physical. Presumably, a tissue injury component exists in most chronic whiplash-associated disorder victims that becomes aggravated in those who are susceptible to biopsychosocial factors. As with many other controversial health care topics, the answer to the debate probably lies somewhere in the middle.

The significance of cervical sagittal alignment for nonrecovery after whiplash injury

“…This has led to the conclusion among certain groups that whiplash injuries do not exist or that WAD is a fraud diagnosis [114]. Even if expectations of recovery appear to have some prognostic value [115], it is surely not the only explanation for the poor recovery rate seen in numerous reports [116]. On the other hand, strictly physical causes of non-recovery after whiplash trauma are not likely to explain the symptoms for most patients with poor outcome.…”

“As If Neck Injuries Did Not Exist”: An Interview Study of Patients’ and Relatives’ Perceptions of Web Information on and Management of Whiplash Injuries in Sweden

“…About half of the patients with WADs have persistent pain and disability [7]. However, there are still conflicting views on etiology and pathophysiology [8], and so, whiplash injury remains a controversial subject, ranging from its definition to complex medical and legal issues [9,10].…”

“…With highly debated issues like whiplash injuries [9,10], it is important to involve patients in the design of patient information, so that their ideas and needs can be incorporated. This way, the information compiled can be made more relevant to the target group [15].…”

Whiplash Syndrome Reloaded: Digital Echoes of Whiplash Syndrome in the European Internet Search Engine Context

“…Accident victims with acute symptoms from rear end collisions generally view this as a benign injury not requiring any medical attention” [ 35 ]. Thus, it has been “hypothesized that cultural [ 36 ] and psychosocial [ 37 - 39 ] factors may be important in explaining why accident victims in some other societies report chronic symptoms. Such factors may include expectation of disability, symptom amplification as a result of this expectation, the effects of inappropriate therapy, insurance [ 40 ], and attribution of symptoms from nonaccident related causes (spontaneous symptoms, occupational symptoms, symptoms before an accident being amplified after an accident)”[ 35 ].…”