Houston Methodist. Leading Medicine

Neck FAQ

Question:

I rear-ended someone last month who is making a mountain out of a molehill. She is claiming she has a severe whiplash injury from the accident. I was only going five miles per hour when it happened. The insurance companies will duke it out. But I'm sure I'll be paying higher premiums for it. Is there any way to prove this lady doesn't really have such a severe problem as she says?

Answer:

Whiplash is defined as a sudden extension of the cervical spine (backward movement of the neck) and flexion (forward movement of the neck). This type of trauma is also referred to as a cervical acceleration-deceleration (CAD) injury. Rear-end or side-impact motor vehicle collisions are the number one cause of whiplash with injury to the muscles, ligaments, tendons, joints, and discs of the cervical spine. The condition can be nonspecific meaning that besides the patient's report of symptoms, there is no visible evidence of damage. What's most puzzling is that some people have what appears to be a minor accident and suffer a major whiplash injury while others have a major accident and walk away with a little soreness that goes away in a few days. And despite many studies on whiplash injuries, we still don't know why some people get better quickly while others suffer head and neck pain for months to years after the injury or accident. It's likely there are central mechanisms (at the brain and spinal cord level) that make pain receptors called nociceptors super sensitive. It has even been suggested that something was going on even before the injury. Patients with chronic whiplash may have a hypersensitivity response early on after the injury. Scientists are trying to explain this phenomenon. Does it mean these patients already had altered pain functions before the accident? Did the accident bring about an even greater sensitivity and response to pain stimulus? There are no answers to these questions yet. And because there's no way to know for sure, insurance companies take as much time as they need to investigate the accident before making a response and settling the case. Helge Kasch, et.al. Deep Muscle Pain, Tender Points and Recovery in Acute Whiplash Patients: A 1-year Follow-Up Study. In Pain. November 15, 2008. Vol. 140. No. 1. Pp. 65-73.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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