Whiplash Treatment Benefits from Benign Neglect

Aggressive medical care of a whiplash injury is associated with a longer time to recovery than minimal care, claims a new study.

Researchers at the University Health Network (Toronto, Canada) looked at medical and insurance records of 1,693 adult patients in the Canadian province of Saskatchewan who had claims for whiplash between July 1, 1994 and December 31, 1994. The cut-off date was chosen because the province's insurance system changed at the end of 1994 from a tort-based to a no-fault system. The primary endpoint of the analysis was time to recovery, defined as the number of days between the beginning and the end of the insurance claim.

The researchers found that patients who visited a family doctor twice or less (but for whom the submitted diagnosis was not whiplash) did best, with a median time to recovery of 323 days, followed by those who had one or two visits to the doctor, at 362 days, and patients with more than six visits to a chiropractor, at 363 days. The worst recovery time was for patients who made any number of visits to a family doctor, combined with more than six visits to a chiropractor, who had a median time to recovery of 689 days. The study was reported in the June 2007 issue of the journal Arthritis Care & Research.

"The results support the hypothesis that the prognosis of whiplash injuries is influenced by the type and intensity of care received within the first month after injury,” concluded Pierre Côté, D.C., Ph.D., and colleagues.

According to the researchers, one possible explanation for the finding is that over-reliance on medical care is a form of passive coping strategy, which reinforces the view that whiplash often leads to disability. In contrast, minimal care that promotes activation of the injured region is more likely to result in a quicker recovery.


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