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PROPOSED TREATMENT INTERVENTIONS FOR WHIPLASH ASSOCIATED DISORDERS.

7th Congress of the European Federation of National Associations of Orthopaedics and Traumatology, Lisbon - 4-7 June, 2005



Abstract

Victims of motor vehicle accidents often seek health care following whiplash injuries. Their complaints (whiplash associated disorders, WAD) are classified on a 1–4 scale developed by the Quebec task force (QTF) in 19951. A number of victims will not recover, developing chronic symptoms instead2. The pathophysiology of the complaints following a whiplash injury is largely unknown. Several different treatments are currently employed by health professionals to treat victims of whiplash injuries in the acute and chronic phase of the disorder.

Responding to the acute symptoms with activity (act-as-usual and exercise) results in improved outcome3. There is evidence that sick-leave may be reduced by high-dose methylprednisolone given within 8 hours of injury in patients with QTF grade 3 WAD3.

Approximately 50 % of patients with chronic WAD suffer from zygapophyseal joint pain that will be relieved for a period of several months if treated with percutaneous radiofrequency neurotomy3. Moderate evidence supports multimodal rehabilitation programs for increasing levels of function3 and coordination exercise to reduce pain in chronic WAD3.

State-of-the-art treatment for acute WAD is available and needs to be implemented.

Further research on the treatment of chronic WAD should focus on the patients’ cognitions and movement behavior.

Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.

1 Spitzer WO, Skovron ML, Salmi LR et al (1995) Scientific monograph of the Quebec Task Force on Whiplash Associated Disorders: redefining “whiplash and it’s management. Spine20(8 Suppl):1S–73S Google Scholar

2 Rosenfeld M, Seferiadis A, Carlsson J, Gunnarsson R (2003) Active intervention in patients with whiplash-associated disorders improves longterm prognosis: a randomized controlled clinical trial. Spine28(22):2491–8. Google Scholar

3 Seferiadis A, Rosenfeld M, Gunnarsson R (2004) A review of treatment interventions in whiplash-associated disorders. Eur Spine J13(5):387–397. Google Scholar