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2001. Whiplash – the standard model doesn’t work.

May 24, 2012
by Andrew@Reliabilityoxford.co.uk
0 Comment
If the standard biomechanical model of causation doesn’t have any practical utility, why is it so popular? It may be that no credible alternative has been proposed, but that doesn’t mean a defectice model should be adhered to. Defective models lead to defective assumptions and defective claims handling.

Evidence from:

R Ferrari. Spine. October (2001) Vol. 26 #19 p 2063.
An editorial on the subject of research into whiplash neck injury.
There is consensus that direction of vehicle impact is not prognostic of acute or chronic problems or litigation status. So if direction doesn’t matter, protection in vehicle is irrelevant. So why continue to focus research into protection from just one direction?
The best treatments take no account of detailed pathology, so why study it any more? Good treatments such as nonspecific exercise regimens and general advice do not require deep understanding of pathology.
Identification of an acute lesion would not explain why some develop chronic pain and disability problems and others do not, but it does have value if it would help with convincing the patient they were not being dismissed as malingerers/liars.
Comment
The main targets of the editorial are researchers who are bound to a bio mechanical model of injury. In the case of whiplash neck injury the most significant problems are not related to pathology or direction of impact.
The biopsychosocial model of soft tissue injury is still not universally accepted.

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