Chronic whiplash leads to a wide variety of symptoms, many of which are medically unexplained. Sufferers of chronic whiplash frequently report somatic symptoms from areas of their body not affected by neck trauma, such as sleep disturbances, shortness of breath, and gastrointestinal symptoms.
There are two competing hypotheses to explain why chronic whiplash symptoms such as these develop. The first considers both chronic whiplash and the relating symptoms to be the result of a specific, organic injury. The second considers chronic whiplash to be a functional somatic syndrome, in which the symptoms result from society-induced expectations, along with amplification of the initial symptoms.
A team of researchers recently sought to examine the prevalence of physical symptoms beyond those directly related to whiplash injuries. They used data from the Norwegian “Hordaland Health Study,” a population-based study involving nearly 14,000 participants, of whom 403 reported chronic whiplash. The tendency for somatization was measured using a list of 17 somatic symptoms covering a range of different organ systems and body parts.
Chronic whiplash was associated with increases of all 17 somatic symptoms included in the study. The authors argue that this increase in symptoms challenges the standard organic injury model, suggesting that chronic whiplash may be a functional somatic syndrome.
While several studies have examined symptoms of headache, dizziness and joint/muscle pain in whiplash patients, there has been little research on other somatic symptoms. The authors outlined various theories that attempt to explain the increase in symptom reporting among chronic whiplash patients: stress system responses can produce hormone changes that trigger hyperalgesia and allodynia; central sensitization can lead to the perception of pain in other parts of the body; and fear-avoidance, expectations, and anxiety/depression can contribute to chronicity.
“The debate over whiplash being a functional or organic disorder is by far settled by this study,” the authors wrote. Still, they concluded that patients in their study resemble “the diffuse and non-specific profile presented by individuals suffering from functional somatic syndromes.” They suggested that doctors continue encouraging their patients to stay active, use posture correction, and undercut any alarming expectations patients may have about the clinical course of their injuries.
Solbjørg, MM et al. Somatic symptoms beyond those generally associated with a whiplash injury are increased in self-reported chronic whiplash. A population-based cross sectional study: the Hordaland Health Study (HUSK). BMC Psychiatry 2012; 12 (129): doi:10.1186/1471-244X-12-129.