Whiplash and Occupational Disability

Whiplash is the result of sudden trauma, usually related to an accident, in which the injured person’s car is struck from behind, in front, or from one side.The injury is due to rapid acceleration of the head, as in a “whip-crack” action, often resulting in headache, neck pain, and sometimes loss of memory or ability of concentration.

 

There are many reports of whiplash and crash factors that can predict who will be left with a disability from such an injury. Previous reports have suggested that female gender (due to a thin neck), older age (due to less flexible joints), marital status (due to stress if divorced or single), heavy manual labor, self-employment , previous psychological problems, the inability to concentrate, catastrophizing by pain and fear of relapse from regular activity have been common themes discussed in research articles.

 

To rank these potential risk factors for prolonged recovery and disability, a February 2009 study looked at this question and reviewed 879 claims. Those involved in car accidents were sent questionnaires requesting information about the accident, the injuries that occurred, their current complaints, and questions about work and disability.

 

These questionnaires were sent again 6 and 12 months after the date of the accident. Of the 879 claims, 59% were found to have work disabilities. The most important factors were age and concentration, complaints that were identified at the one-month mark were more predictive of those who would still be disabled at one year. What was interesting was that most of the previously accepted risk factors for long-term disability, such as intensity of manual work or educational level, were not helpful in predicting long-term disability before the one-year point, with only the age and impaired concentration identified.

 

The authors suggested that we should focus treatment on complaints related to concentration, that is, brain-related functions, rather than just managing the patient’s physical complaints. What was interesting was that most of the previously accepted risk factors for long-term disability, such as intensity of manual work or educational level, were not helpful in predicting long-term disability before the one-year point, with only the age and impaired concentration identified.

 

The authors suggested that we should focus treatment on complaints related to concentration, that is, brain-related functions, rather than just managing the patient’s physical complaints. What was interesting was that most of the previously accepted risk factors for long-term disability, such as intensity of manual work or educational level, were not helpful in predicting long-term disability before the one-year point, with only the age and impaired concentration identified. The authors suggested that we should focus treatment on complaints related to concentration, that is, brain-related functions, rather than just managing the patient’s physical complaints.

 

A condition called mild traumatic brain injury or post-concussion syndrome,it can apply to people injured in car accidents who have lost some of the higher cortical or brain-related functions. Although most patients will usually recover from this, a minority will not. Therefore, it is important for patients and healthcare providers to be acutely aware of symptoms such as memory loss (primarily short-term), loss of train of thought (forgetting what you were about to say), or Difficulty formulating what you want to say (getting the words right). Many patients are reluctant to say anything to their health care provider, as they often feel embarrassed and don’t feel comfortable talking about it.

 

They often think they are “…just going through a phase”, and that it may “sound weird” if they talk about these symptoms and thus avoid even mentioning them during the story. In the end, most patients are relieved after discovering that “it’s not all in their head” and feel more comfortable talking about it when they know that their healthcare provider is aware of their cognitive dysfunction and that it is a problem. real. As one patient put it, “…I thought I was going crazy,” when in fact these sometimes quite subtle symptoms are very important clues to identify this condition so that immediate attention can be directed to these problems. most patients are relieved after discovering that “it’s not all in their head” and feel more comfortable talking about it when they know that their healthcare provider is aware of their cognitive dysfunction and that it is a real problem.

 

As one patient put it, “…I thought I was going crazy,” when in fact these sometimes quite subtle symptoms are very important clues to identify this condition so that immediate attention can be directed to these problems. most patients are relieved after discovering that “it’s not all in their head” and feel more comfortable talking about it when they know that their healthcare provider is aware of their cognitive dysfunction and that it is a real problem. As one patient put it, “…I thought I was going crazy,” when in fact these sometimes quite subtle symptoms are very important clues to identify this condition so that immediate attention can be directed to these problems.