Results of a multimodal treatment program for patients with chronic symptoms after a whiplash injury of the neck

Spine (Phila Pa 1976). 2000 Jan 15;25(2):238-44. doi: 10.1097/00007632-200001150-00016.


Study design: A descriptive case series pre- and post-treatment design, including a 6-month follow-up.

Objectives: The objective of this study was to document the improvements of patients with chronic symptoms after a "whiplash" injury of the neck, who attended a 4-week multimodal treatment program at the Rug AdviesCentra Nederland.

Summary of background data: To the authors' knowledge, no studies have been conducted on the effectiveness of multidisciplinary treatment of chronic symptoms after whiplash injury.

Methods: Twenty-six patients who experienced Quebec type 1 or 2 lesions of the neck (whiplash) with persisting symptoms of longer than 6 months' duration participated in the study. The measures included were pain intensity (according to the visual analog scale), number of painful sites (determined by pain drawing), self-reported disability Quebec Back Pain Disability Scale; and symptoms of somatic and psychological distress and cognitive symptoms (according to selected Minnesota Multiphasic Personality Inventory-2 scales). Furthermore, objective outcome criteria were used regarding return to work, medication, and medical and paramedical treatment. Statistical and clinical significance of treatment results were both assessed.

Results: The patients' symptoms improved significantly on nearly all self-report measures. Their scores for objective outcome criteria reported during the 6-month follow-up evaluation were: complete return to work (65%); complete or partial return to work (92%); no use of analgesics in the past 6 months (58%); and no medical or paramedical treatments in the past 6 months (81%).

Conclusion: These early results indicate that a multimodal treatment program has the potential to be an effective treatment for patients with chronic symptoms after a whiplash injury of the neck--a group of patients who have in the past been considered intractable or, at the very least, puzzling.

MeSH terms

  • Activities of Daily Living
  • Adult
  • Analysis of Variance
  • Combined Modality Therapy
  • Depression / therapy*
  • Fatigue / therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neck Injuries / therapy*
  • Pain Measurement
  • Personality Tests
  • Physical Therapy Modalities
  • Program Evaluation
  • Treatment Outcome
  • Whiplash Injuries / therapy*