More than just a pain in the neck

Consumer Desk/Whiplash: One of the commonest, yet most controversial, crash injuries is whiplash, finds Susan Jones

Consumer Desk/Whiplash: One of the commonest, yet most controversial, crash injuries is whiplash, finds Susan Jones

Whiplash is controversial and often surrounded by conflicting ideas. The injuries affect tens of thousands of people each year and can cause debilitating back, neck, and nerve injuries. Indeed, research carried out in the US has suggested that whiplash victims may be more susceptible to Alzheimer's Disease in old age.

But what exactly is it? Whiplash is caused when the head is suddenly accelerated in one direction, then the other and the neck is hyper-extended, then hyper-flexed. This stretching and tearing of muscles, ligaments, and other soft tissue results in oedema and microhaemorrhage; soft tissue damage and cellular destruction release painful chemical irritants.

The force of the injury may cause neck fracture or even spinal cord trauma. Signs and symptoms, such as pain and oedema, may be delayed for up to 48 hours after the injury.

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In an article in the American Family Physician Grace Brooke Huffman noted that few adequate clinical trials have studied the treatment of whiplash injury, and that it is difficult to treat because patient complaints are typically vague.

"Although the traditional treatment method has been a soft cervical collar to provide rest and restrict motion for the neck," she advises, "use of the collar has actually been shown to slow healing. In one study patients who received active treatment (rotational exercises 10 times every hour as soon as possible within the first four days after the injury) experienced less pain and more cervical flexion than those who were given the standard treatment."

Whiplash injuries cost the insurance industry millions every year, and litigation in these cases clogs up courtrooms globally. It is a highly contentious field with opinions divided in the legal and medical professions as well as society itself as to whether those with whiplash are genuinely injured - or are just "scamming".

The Internet is full of sites where you will get endless reams of advice on how to make a claim: one, for example, advising rather pedantically that: "If you have a road accident you can claim against the other driver, they will be insured and their insurance company will end up paying." The claims process is explained, including such issues as time limits on making a claim, and payment of interim damages.

What of the motor industry's view on all this? Last year a BBC report said the AA has identified three major makes of cars which it claims do not offer enough protection against the effects of collision from behind.

Leading manufacturers have been urged to offer motorists more protection from whiplash by the AA, which carried out the tests in conjunction with other motoring organisations. According to the AA the legal minimum for seat design does not go far enough and should be improved. The tests also showed that taller people were more susceptible to whiplash injury.

The Mercedes A-class was found to have inadequate safety aspects, while the Renault Megane and the Fiat Bravo offered little protection to people over 5ft 7" in height. In contrast the Volvo V70 got top marks, as did the Ford Mondeo.

Both were found to have an "active" seat which moves in a collision to prevent excessive head movement. The results were carried out after tests simulating a low impact collision from behind on 11 popular car models.

The AA argues that seats and headrests can be better designed by all major manufacturers, and motorists should be more aware of proper safety which can lessen the impact of a rear-end collision. Also, the top of the headrest should be in line with the eyes and the headrest should be as close to the back of the head as possible.

"It's up to drivers and front-seat passengers to make sure that they adjust head restraints properly, but car manufacturers must make sure they can actually do it," says Chris Patience, the AA's head of technical policy.