The Whiplash Disease Reconsidered

Abstract

The natural course of the whiplash disease is reconsidered in relation to the predominant view of its cause. It is assumed that a whiplash-type trauma is causing an acute tissue injury such as a distortion or sprain in the neck followed by neck pain and headache, which then tends to become a chronic pain condition. We conclude that the whiplash disease typically evolves following a minor trauma without any signs of a tissue injury. It presents with central neuromotor dysfunction, such as electromyography (EMG) hyperactivity and abnormal activation patterns associated with dyscoordination of the involved and adjacent muscle groups. This indicates a central neurological rather than a peripheral traumatic pathology. This view places the cause of the whiplash disease within the central nervous system, and, in concordance with the EMG abnormalities and motor dyscoordination, we suggest the term cervical spinal dyssynergia for this pathology. It provides a new paradigm for further investigations of this disease as well as a window for possible specific neuropharmacological therapy directed towards dysfunctional neuromotor control.

Tension-type headache and low back pain reconsidered

“…Further studies are warranted. Recently, we reconsidered the whiplash disease grade 2 and concluded that its natural cause and clinical features are better explained as a neurological rather than a post-traumatic condition and we suggested the term spinal cervical dyssynergia to describe the neurology of this condition (30). In a previous study, we observed that patients with whiplash disease grade 2 presented with identical clinical symptoms and signs and head movement discoordination as observed in patients with tension-type headaches (5), and we suggested that tension-type headache and whiplash disease may be regarded as the same basic disease occurring either spontaneously or initiated by a minor low energy trauma, respectively.…”

Exploratory Study of Associations and Agreement between Prognostic Patient-Registered Factors, Physiotherapists’ Intuitive Synthesis, and Patient-Reported Factors in Whiplash-Associated Disorders

“…However, the unitary time dimension of soft-tissue healing after whiplash injury is under discussion [ 5 , 6 ]. The impact of whiplash injury is restricted not only to lesions of the cervical spine but also affects structures of the peripheral and central nervous systems.…”

“…Pain and sensory functions are indicative of sensitization of the peripheral and central nervous systems [ 7 , 8 , 9 , 10 , 11 ]. The high prevalence of all these complaints, combined with the lack of relationship between collision-related factors and signs of tissue injury, are suggestive of a central neurological disorder rather than a peripheral traumatic disorder [ 5 , 6 ]. This category of nociplastic pain is mechanistically distinct from nociceptive pain, which is caused by ongoing inflammation and nociceptive information [ 12 , 13 , 14 ].…”