Understanding whiplash

Whiplash: evidence base for clinical practice.

Michele Sterling, Justin Kenardy. Sydney: Elsevier 2011 (xv + 197 pp, $77.25). ISBN 9780729639463.

WHIPLASH is a controversial, but widely accepted, “diagnostic” term that describes a putative causal mechanism for a constellation of symptoms that are generally not underpinned by recognisable pathology. This reference book has the stated aim: “to bring together current knowledge of the whiplash condition that will allow all stakeholders involved in the management of patients with whiplash, from clinicians to policy makers, to gain greater understanding of this condition”.

Whiplash research is important, as up to 50% of people with this condition do not recover fully and up to 30% remain moderately to severely disabled.

The editors of this book, Michele Sterling (associate professor of physiotherapy) and Justin Kenardy (professor of psychology), are both from the University of Queensland, and have both made significant contributions to the university’s Centre of Clinical Research Excellence in Spinal Pain, Injury and Health. They are well positioned, therefore, to comment on contemporary work in their fields, particularly as considerable research concerning whiplash arises from their institution. They have also attracted contributors from a spectrum of disciplines including neurosurgery, psychology, physiotherapy, rehabilitation, epidemiology, engineering, economics and law.

The book comprehensively elucidates contemporary research, particularly in the fields of physiotherapy and psychology. However, as it observes, there is little or no evidence to guide the clinician who is managing the whiplash patient. There is virtually no evidence that confirms a link between symptoms and pathology, and there is also very little established evidence-based management.

The chapters on law, compensation and insurance are worthwhile reading for medical practitioners involved in the medicolegal aspects of whiplash. A series of case studies is also included.

The book is recommended for scientists involved in physical and psychological rehabilitation research into whiplash. It confirms the paucity of evidence related to the whiplash construct. However, it does not assist the clinician who is interested in providing evidence-based whiplash management.