Citation

Sterling M, McLean SA, Sullivan M, Elliott J, Butenhuis J, Kamper SK. Spine 2011; ePub(ePub): ePub.

Affiliation

Centre for National Research on Disability and Rehabilitation Medicine (CONROD), The University of Queensland, Australia Departments of Anesthesiology and Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Department of Psychology, McGill University, Montreal, Canada Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA Medical Department Univé Insurance, and Department of Health Sciences, University Medical Center Groningen, University of Groningen, the Netherlands The George Institute for Global Health, University of Sydney, Australia.

Copyright

(Copyright © 2011, Lippincott Williams and Wilkins)

DOI

10.1097/BRS.0b013e318238853f

PMID

22020604

Abstract

STRUCTURED ABSTRACT: Study Design. Non systematic review and discussion of the aetiological processes involved in whiplash associated disorders (WAD).Objective. To summarise the research and identify priorities for future research.Summary of Background Data. Whilst there is convergent evidence of a peripheral lesion in some individuals following whiplash injury, in the majority of injured people, a lesion cannot be established with current imaging technology. Therefore it is important to consider processes that underlie the initiation and maintenance of whiplash pain as this may allow for the development and testing of interventions to target these processes and improve outcomes.Methods. A non-systematic review was performed to summarize current knowledge regarding potential aetiological processes involved in the initiation and maintenance of WAD and to identify future research priorities.Results. There are several aetiological processes potentially involved in the initiation and maintenance of WAD. These include augmented nociceptive processing; stress system responses; psychosocial and sociocultural factors. Recent findings also indicate that morphological changes in the neck muscles of injured people show some association with poor recovery but the mechanisms underlying these changes are not clear. Preliminary evidence indicates associations between these processes. Future research priorities include: more sophisticated investigation and analysis of interactions between the various processes; whether the modification of these processes is achievable and if modification can improve health outcomes; to clarify factors involved in the initiation of whiplash pain versus those involved in symptom maintenance.Conclusion. Research to date indicates that there are several physiological and psychological aetiological processes that may underlie the initiation and maintenance of whiplash related pain and disability. Further research is required to determine relationships and interactions between these factors and to determine if their modification is possible and will improve outcomes following injury.

Language: en