A Symptomatic Classification of Whiplash Injury and the Implications for Treatment

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:   Frankp@chiro.org

FROM:   Journal of Orthopaedic Medicine 1999;   21 (1):   22–25

Khan S, Cook J, Gargan M, Bannister G

University Department of Orthopaedic Surgery, Bristol, UK

Objective:   To determine which patients with chronic whiplash will benefit from chiropractic treatment.

Design:   Retrospective review by structured telephone interviews of 93 consecutive patients seen in chiropractic clinic.

Setting:   Independent chiropractic clinic in a large city.

Subjects:   93 patients, 68 female.

Main outcome measure:   Gargan and Bannister grading pre and post treatment.

Results:   Three groups of patients were recognised. Group 1 consisted of patients with isolated neck pain associated with a restricted range of neck movement. Group 2 consisted of patients with neurological symptoms or signs associated with a restricted range of movement. Group 3 comprised patients who described severe neck pain but all of whom had a full range of neck movement. Patients in this group often described an unusual group of symptoms, with a bizarre, non-dermatomal pain distribution. There was a significant difference in outcome between the three groups (p<0.001) with only groups 1 and 2 improving following chiropractic manipulation.

Conclusion:   Whiplash injuries are common. Chiropractic is the only proven effective treatment in chronic cases. Our study enables patients to be classified at initial assessment in order to target those patients who will benefit from such treatment.

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