Soft-tissue Injuries of the Cervical Spine 15-year Follow-up Reference: Journal of Bone and Joint Surgery (British) November 1996, Vol. 78-B, No. 6, pp. 955-7 B. Squires, M. F. Gargan, G. C. Bannister: From the University of Bristol, England KEY POINTS FROM DAN MURPHY At a mean of 15.5 years post whiplash trauma, 70% of whiplash-injured patients continued to complain of symptoms referable to the original accident. Long-term symptoms from whiplash injury include neck pain, arm paraesthesia, back pain, headache, dizziness, and tinnitus. Women and older patients have a worse outcome from whiplash injuries. Radiating arm pain is more common in those with severe symptoms. Between 10 and 15 years after the accident, 18% of the patients had improved, whereas 28% had deteriorated. Soft-tissue injuries to the cervical spine may give persisting symptoms. Most whiplash-injured patients reach their final state by two years after being injured, but this study shows ongoing symptom fluctuation between years 10 to 15. At the 15-year follow-up, neck pain was present in 65% and low-back pain was present in 48%. 80% of women and 50% of men continued to have symptoms at 15 years. Back pain and tinnitus increased between years 10 and 15. Symptoms remained static in 54%, improved in 18% and worsened in 28%. Degenerative changes are associated with a worse prognosis for recovery. 60% of symptomatic patients had not seen a doctor in the previous five years because the doctors were unable to help them. 18% had taken early retirement due to health problems, which they related to the whiplash injury. Whiplash symptoms do not improve after settlement of litiga tion. Most radiating pain is referral from the facets, and not radicu- lar. Chronic whiplash symptoms will cause an abnormal psycho logical assessment after 3 months. In this study, 100% of patients with severe ongoing problems had cervical spinal degeneration. A 1978 graduate of Western States Chiropractic College. Dr. Dan Murphy is on the faculty of Life Chiropractic College West, and is the Vice President of the International Chiropractic Association. For more information, visit www.danmurphydc.com\
