Whiplash is a profoundly controversial area. There are probably four main factors that drive this controversy. The first issue involves not just the enormous economic cost of whiplash for some countries – £3 billion per annum in the UK alone – but the variation in costs and claims frequency between countries. If we look at the UK we find an average payout of about £2,500 per claim. In Switzerland however the average payout is in excess of €30,000 per claim. In the UK about 75% of all claims for bodily injury following motor vehicle accidents are for whiplash injury. In France however just 3% of all bodily injury claims are whiplash related.
‘A Medico-legal Illusion…..’
The second issue relates to a number of ‘authorities’ who, having reviewed whiplash injury, have concluded that it is nothing but a ‘medicolegal illusion.’ What is it that leaves the door ajar to such criticism? It is probably a combination of facts:
- the index injury – the low speed rear impact collision – can appear to involve negligible levels of force (see here for a brief summary of the research on this)
- there is no objective test for whiplash injury
- whiplash injury symptoms are entirely subjective
The third main issue relates to the role of litigation and compensation in whiplash injury. There’s some very interesting evidence from the University of Queensland that suggests that filing a claim for whiplash injury exacerbates pain, disability and psychological symptoms in whiplash injury. So putting in a claim could quite literally be bad for your health.
Chronic problem
The fourth main point relates to our effectiveness as healthcare professionals: although it is now possible to identify those at increased risk of poor recovery following whiplash injury, there appears to be little we health professionals can do to stop the progression from the acute to the chronic stage of the problem, and once patient’s become members of that chronic whiplash injured sub-group – usually about 20 to 25% of all whiplash injured patients – there appears little we can do as health professionals to get people out of that sub-group. See here for further discussion.
References
Association of British Insurers (2008) Tackling Whiplash, Prevention, Care, Compensation.
Malleson A: Whiplash and other useful injuries (2002) Quebec, Canada McGill-Queen’s University Press.
Sterling, M., J. Hendrikz, et al. (2010). “Compensation claim lodgement and health outcome developmental trajectories following whiplash injury: A prospective study.” Pain. 150 (1): 22-28.
Chappuis G and Soltermann B (2008) Number and cost of claims linked to minor cervical trauma in Europe: results from the comparative study by CEA, AREDOC and CEREDOC. Eur J Spine 17: 1350-1357.