Journal Article

The whiplash debate

Merskey, Harold

2003

Overview

The Norwegian-Lithuanian study3 was the first controlled study to examine the association between rear-end collisions and the development of chronic neck pain and headaches. Following the sudden occurrence in Norway of a devastating \"epidemic\" in which 70 000 people, from a population of 4.5 million, claimed to have been disabled by whiplash, Harald Schrader and his Norwegian colleagues wanted to learn more about the course of whiplash uncomplicated by the availability of insurance and fashionable beliefs that whiplash causes disabling symptoms. They chose Lithuania, a country in which there was no personal injury insurance and where few people had heard of whiplash. To reach significance in a study of whiplash, a large number of subjects is needed because the prevalence of neck pains and headache in the community is high, and any possible addition caused by whiplash injury is small. This means that for any individual whiplash claimant, the chances of persistent symptoms being due to the collision rather than to the ordinary exigencies of life are much below the 50% probability required by civil law for the perpetrator of the accident to be held financially liable. If lawyers and medical expert witnesses refrained from bringing to court \"junk\" whiplash science, judges would seldom award compensation for whiplash complaints. Given that the high cost of auto insurance premiums reflects the excessive cost of whiplash claims, premiums could thereby be reduced to more manageable levels. Studies from Western countries indicate that 15% to 58% of people with a whiplash injury experience the late whiplash syndrome.5-9 Our 2 controlled studies10,11 were conducted in Lithuania, a country where whiplash injury provides little opportunity for \"secondary gain\" and where there is little awareness that whiplash injury is a reputed cause of chronic pain and disability. Altogether, we evaluated 412 people who had been involved in rear-end collisions, which gave an estimated minimum of 180 subjects with acute whiplash injury (i.e., acute symptoms).12 According to previous reports this number should have yielded between 27 and 104 people with late whiplash syndrome. Yet we identified no subjects with chronic symptoms related to the collision. If the late whiplash syndrome does exist, it seems to occur very infrequently in Lithuania.

• Publisher: CMA Impact, Inc
• Subject: Accidents, Traffic / Compensation / Fraud / Health care / Humans / Letters / Malleson, Andrew / Merskey, Harold / Rosser, WW / Whiplash / Whiplash Injuries - diagnosis