An Introduction to Whiplash

Whiplash is one of the most controversial conditions in the health care field and has major implications in the legal and insurance industries as well.

In 1989, the agency which heads up the insurance business in the Canadian province of Quebec sponsored the largest in-depth look into the phenomenon of whiplash and whiplash-related disorders ever undertaken. The Quebec Task Force, as it was called, brought out its report in 1995 and stated that ‘Whiplash is to the automobile, what low back pain is to the workplace.’

The only definitive fact that can be said about whiplash is that it occurs in motor vehicle accidents. All other aspects of the whiplash phenomenon are subject to a degree of debate and controversy. The types of injuries sustained, the mechanics and degrees of these injuries, the validity and legitimacy of the injuries, the best treatments, the effect of litigation on the clinical outcome, the psychological factors, and the concept of secondary gain, are all issues open to debate in the discussion of whiplash. Not even insurance statistics concerning the incidence of whiplash can find consensus. Statistics range from 3.8 to 14.5 per thousand traffic accidents in the U.S. to 20% of all motor vehicle accidents in Quebec to 68% of all claims in Saskatchewan.

Even scientific literature on the subject is full of controversy. The Quebec Task Force reviewed over 10,000 articles on the subject and subsequently rejected most due to irrelevancy or on the grounds of poor scientific merit. Only 62 of 10,000 scientific articles were considered worthy of study by the Task Force.

The Quebec Task Force, made up of a cross-section of health care clinicians and researchers, was itself widely praised and just as widely criticized. This was to be expected in view of the great variety of opinions on the subject as well as the fact that the study was sponsored by the auto insurance industry. However, one or two studies, no matter how meritorious cannot be expected to provide all the answers nor address all the ongoing health and legal issues to everyone’s satisfaction. The fact that many of the Task Force’s recommendations have whole-heartedly been adopted by many premium and cheap auto insurance companies itself raises suspicions that the report may have been somewhat self-serving.

One of the most controversial aspects of the report was that it stated that after one year post-accident only 1.8% of whiplash victims still suffered from chronic neck and head pain. Obviously, this was music to the ears of insurance adjusters and gave ample grounds to terminate benefits aggressively. The fact that several other researchers have since placed the figure at closer to 12% has barely fazed insurance officials in their quest for profits.