Whiplash associated disorders have become an international medicolegal and social dilemma. Whiplash injuries are a major health and economic problem around the world.
In the UK, their annual cost to the economy is about £2,553 million (1990 prices), representing about 18% of the total costs of all road traffic collisions and 0.4% of the Gross Domestic Product .

Definition
‘Whiplash ’was first reported in the medical literature in 1945 to help clarify ‘obscure cervical spine injuries resulting from hyperflexion of the neck and associated with extensor recoil due to the mobility of the cervical spine'(Davis 1945).
Whiplash is caused by the neck being forced to move beyond its normal range.
The Quebec task force (QTF) on whiplash associated disorders (WAD) defined whiplash as “bony or soft tissue injuries” resulting “from rear-end or side impact, predominantly in motor vehicle accidents, and from other mishaps” as a result of “an acceleration-deceleration mechanism of energy transfer to the neck”.
One of the most important developments is the WAD classification system. This classification system (Box 1) may be helpful in assessing the severity of injuries and deciding when to refer patients for specialist medical opinion.

QTF classification of whiplash-associated disorders

Grade      Classification
0               No complaint about neck pain.
                  No physical signs.

I               Neck complaint of pain, stiffness or tenderness only.
                 No physical signs.

IIA          Neck pain.
                Motor Impairment.
                Decreased ROM.
                Altered muscle recruitment patterns (CCFT)
                Sensory Impairment.
                Local cervical mechanical hyperalgesia.

IIB        Neck pain. 
              Motor Impairment.
              Decreased ROM.
             Altered muscle recruitment patterns (CCFT).
             Sensory Impairment.
             Local cervical mechanical hyperalgesia.
             Psychological impairment.
             Elevated psychological distress (GHQ-28,.TAMPA).

IIC      Neck pain.
Motor Impairment.
Decreased ROM.
Altered muscle recruitment patterns.
Increased Joint position error (JPE).
Sensory Impairment.
Local cervical mechanical hyperalgesia.
Generalised sensory hypersensitivity(mechanical, thermal,
Some may show Sensory nervous system disturbances.
Psychological Impairment.
Psychological distress.
Elevated levels of acute posttraumatic stress.

III       Neck pain.
           Motor Impairment.
           Decreased ROM.
           Altered muscle recruitment patterns.
           Increased JPE.
           Sensory Impairment.
           Local cervical mechanical hyperalgesia.
           Generalised sensory hypersensitivity (mechanical, thermal, ).
           Some may show SNS disturbances.
          Psychological Impairment.
          Psychological distress.
          Elevated levels of acute posttraumatic stress.
          Neurological signs of conduction loss including:
          Decreased or absent deep tendon reflexes.
          Muscle weakness.
          Sensory deficits.
IV
            Fracture or dislocation

 

Clinical and Radiographic diagnosis of whiplash