Handbook of Pain Syndromes: Biopsychosocial Perspectives

By Andrew R. Block; Edwin F. Kremer et al. | Go to book overview

Chapter 12
Whiplash Injuries

Robert W. Teasell

University of Western Ontario

Allan P. Shapiro

London Health Sciences Centre,

London, Ontario, Canada

Whiplash injuries are a controversial clinical entity and in the developed industrialized world remain a significant public health problem with significant socioeconomic consequences. In 1990, the Societe d'Assurance Automobile du Quebec, a provincial government no-fault insurance carrier in Canada's second largest province, commissioned a group of clinicians, scientists, and epidemiologists to exhaustively review the scientific literature and make public policy recommendations regarding the prevention and treatment of whiplash and its associated disorders. The stated reasons for commissioning this study reflected a grievous concern with both the magnitude of the problem and the paucity of strategies to effectively address it:

The frequency of the clinical entity labelled as whiplash is high; the residual disability of victims appears significant in magnitude, and the costs of care and indemnity are high and rising. There is considerable inconsistency about diagnostic criteria, indications for therapeutic intervention, rehabilitation and the appropriate role of clinicians at all phases of the syndrome. Little is known about primary prevention of the condition, and virtually nothing is known about tertiary prevention of serious disability. ( Spitzer et al., 1995, p. 10S)


DEFINITION AND SCOPE OF THE PROBLEM

The Quebec Task Force ( QTF; Spitzer et al., 1995) adopted the following definition of whiplash: "Whiplash is an acceleration-deceleration mechanism of energy transfer to the neck. It may result from rear-end or side-

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