Inter Law – Whiplash controversy in medical academia as opinions are divided

Because the biological sciences behind whiplash injuries are presently unknown and because injuries are often not apparent but instead involve ‘invisible’ damage a lot of medical investigations and articles have been written on the subject. Some academics believe that whiplash is more of a social problem than a medical one, claiming that those injured are encouraged to exaggerate their pain, take out legal action and request medical help which they may not necessarily need.

It was in The Journal of the American Medical Association over half a century ago that Gay and Abbot first described a common injury to the neck which they called whiplash. Since that article was published, all the way back in 1953, whiplash incidence in the western world has risen to pandemic proportions.

In 75% of patients whiplash symptoms last more than 6 months and symptoms don’t commonly present until weeks or months after the accident takes place. On average whiplash sufferers lose approximately 8 weeks of work time and the injury is 5 times more common in women than it is in men.

Michael Livingstone MA MD refers to whiplash as a ‘modern epidemic’. In the Journal of The Royal Society of Medicine he wrote: “Despite attention from a profusion of physicians, paramedicals, pain clinics and conferences [whiplash] remains an enigma.” He posits that many of the authors who write about whiplash do not describe the injury in a clear and detailed way. Livingstone says that Gay and Abbott, the first people to write about whiplash were also guilty of this. He adds in his paper that other medical authors usually fail to offer definitions and that definitions from expert to expert widely vary.

Livingstone said that the first step to combating the high incidence rate of whiplash was a mechanical one. He proposed better car seat designs and technological approaches to reducing injury. Livingstone also said that a number of steps could be taken by the medical community to reduce whiplash in the future and that the medical authorities must “Define whiplash injury more clearly”. Medical training, he suggested must be improved and pre-accident symptoms of patients should be taken into account. He added that health care professionals should resist over-treatment, reward patients for ‘becoming well’ rather than remaining ill, reduce the influence of attorneys and especially discourage symptom diaries.

He said that healthcare professionals must examine their own effectiveness, learn from parallels, reduce research bias, communicate better with each other and finally that society must offer greater incentives to accident free drivers.

In a different article which he wrote for the British Columbia Medical Association Livingstone said: “… whiplash injury was described frequently in the American literature after 1953, but not described among British patients in the UK major journals for the next 30 years. Normally a new syndrome described on one side of the Atlantic surfaces on the other side within 3 years. In whiplash injury it did not.

He asks: “Why did British patients, particularly in traffic-dense London, not complain of whiplash symptoms sufficiently to draw researchers’ attention? Why had no researcher commented on the difference between the two countries?” Many academics believe that whiplash is more of a social problem than a medical one and an amount of cynicism towards the illness perhaps unfairly exists. But, until a detailed definition of the injury is agreed upon and the ailment is better understood by doctors everywhere the controversy surrounding the issue will continue to divide opinions in the medical community.

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