Toward optimal early management after whiplash injury to lessen the rate of transition to chronicity

Jull, Gwendolen A., Soderlund, Anne, Stemper, Brian D., Kenardy, Justin A., Gross, Anita R., Cote, Pierre, Treleaven, Julia M. O., Bogduk, Nikolai, Sterling, Michele M. and Curatolo, Michele (2011) Toward optimal early management after whiplash injury to lessen the rate of transition to chronicity. Spine, 36 25S: S335-S342. doi:10.1097/BRS.0b013e3182388449

Author Jull, Gwendolen A.
Soderlund, Anne
Stemper, Brian D.
Kenardy, Justin A.
Gross, Anita R.
Cote, Pierre
Treleaven, Julia M. O.
Bogduk, Nikolai
Sterling, Michele M.
Curatolo, Michele
Title Toward optimal early management after whiplash injury to lessen the rate of transition to chronicity
Journal name Spine   Check publisher's open access policy
ISSN 0362-2436
Publication date 2011-12
Sub-type Article (original research)
DOI 10.1097/BRS.0b013e3182388449
Volume 36
Issue 25S
Start page S335
End page S342
Total pages 8
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Collection year 2012
Language eng
Formatted abstract
Study Design.
Expert debate and synthesis of research to inform future management approaches for acute whiplash disorders.


To identify a research agenda toward improving outcomes for acute whiplash-injured individuals to lessen the incidence of transition to chronicity.

Summary of Background Data.
International fi gures are concordant, estimating that 50% of individuals recover from pain and disability within 3 to 6 months of a whiplash injury. The remainder report continuing symptoms up to 1 to 2 years or longer postinjury. As no management approach to date has improved recovery rates, new clinical/research directions are required for early management of whiplash-injured patients.

A group of multidisciplinary researchers critically debated evidence and current research concerning whiplash from biological, psychological, and social perspectives toward informing future research directions for management of acute whiplash.

It was recognized that effective treatments for acute whiplash are constrained by a limited understanding of causes of whiplash-associated disorders. Acute whiplash presentations are heterogeneous leading to the proposal that a research priority was development of a triage system based on modifi able prognostic indicators and clinical features to better inform individualized early management decisions. Other priorities identifi ed included researching effective early pain management for individuals presenting with moderate to high levels of pain; development of best education/information for acute whiplash; testing the effi cacy of stratifi ed and individualized rehabilitation, researching modes of delivery considering psychosocial modulators of pain and disability; and the timing, nature, and mode of delivery of cognitive-behavioral therapies. Directions were highlighted for future biomechanical research into injury prevention.

The burden of whiplash injuries, the high rate of transition to chronicity, and evidence of limited effects of current management on transition rates demand new directions in evaluation and management. Several directions have been proposed for future research, which refl ect the potential multifaceted dimensions of an acute whiplash disorder.
Keyword Acute whiplash
Cervical Spine
Chronic neck pain
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Discussion Paper 5.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 8 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 13 Dec 2011, 13:48:45 EST by Chesne McGrath on behalf of Medicine - Royal Brisbane and Women's Hospital