Long-term Follow-up of Whiplash Injury of the Neck

Background: Whiplash injury has long-term sequelae, although little has been written about its longterm follow-up. The aim of the present study was to establish the factors affecting long-term outcome of whiplash injury. Methods: This was a retrospective study in the public Russells Hall Hospital (Dudley, UK). Sixty-four patients who had whiplash injury of the neck due to road traffic accidents in 1995, 1996, and 1997 were recruited. All were treated with conservative means. Fifty-four patients replied. They were assessed using the Short Form 36 Health Survey (SF-36) and Whiplash Disability Questionnaire Score (WDQS). Results: Twenty-two patients (40.7%) were still symptomatic 10 years after injury. Eighteen patients (33.3%) had pins and needles sensation in their limbs; 13 (24.1%) had frontal headache; and seven (13%) had occipital headache. The mean WDQS in patients with low back pain was 29.23 and 12.53 for those without back pain. In smokers, the mean WDQS was 32.2 compared with 17.93 in non-smokers. The mean WDQS in those who did not drink alcohol was 26.73 compared with 16.58 in those who drank alcohol. Conclusion: Whiplash injury patients have long-term residual symptoms; mainly pins and needles sensation in their limbs, headache, and dizziness. Increasing age and low back pain are bad prognostic factors. Claiming compensation prolongs the time for recovery. Sex, body mass index, type of treatment, smoking, and alcohol have no association with the incidence of persistent symptoms. However, smoking had a significant worsening effect on the severity of the symptoms in patients with high WDQS. WDQS, SF-36 and time to symptom relief are sensitive outcome measures of these injuries.