The "whiplash" industry and chiropractic wibble
The "whiplash" industry and chiropractic wibble -
A great deal of intelligence can be invested in ignorance when the need for illusions is deep
--Saul Bellow
Like all other GPs in the country, it is rare for a week to pass without me seeing someone who claims to have had a “whiplash” injury. They walk in with a smile on their face and say they have “been advised by”… (insert police/insurance company/great Aunt Bertha) …to get themselves “checked by the doctor” so that it is “on the record”. The stories they give are remarkable similar; usually they have been “rear-ended” whilst stopped at a junction or going on to a roundabout. It happened a few days ago and now they are a "bit stiff".
Are they all malingerers? Are they all cynically trying to rip off their insurance companies? No, many of them are genuine. They truly believe they have a problem.
If you really believe it, it is not a lie
-George Constanza in Seinfeld
In Canada, the Quebec government funded a multi-million pound research project into the effects of whiplash associated disorders (WADS):
- 0 No complaints about neck, no physical signs
- I Neck complaints of pain, stiffness or tenderness only, or tenderness only. No physical signs
- II Neck complaints and musculoskeletal signs (limitation of movement and point tenderness)
- III Neck complaints and neurological signs
- IV Fracture or dislocation
Over the last ten years, I have had one patient who sustained grade IV neck injuries. He was in immediate pain before he (foolishly) got out of the car. The paramedics probably saved his life by getting him flat on his back and putting on a protective collar. He was in hospital for three weeks and, two years later, still has symptoms.
The other four hundred and twenty six (I did a computer search) had no significant injuries. They got out of the car feeling well. Over the next few days they became stiff around the neck and shoulders and it was at this stage that they went to the doctor. Most were Grade I. A few were Grade II. Amazingly, there were a few Grade 0 – why do they even bother to come? I do not know how many have made claims against insurance companies. From figures just released by the ABI, it seems that a lot of them may have done:
The number of claims for whiplash injuries following road accidents is soaring, say British insurance firms. The Association of British Insurers (ABI) says that its members receive almost 1,200 claims of this type every day, worth £2bn a year. The injuries themselves cost the NHS an estimated £8m a year, it says.
Andrew Malleson is an American psychiatrist. He is the author of a wonderful book called
“Whiplash and other useful injuries”
and an expert on accident litigation. He shows how an occult conspiracy between poor medical science and vulnerable, often inadequate, patients has generated the whole bogus, “whiplash” industry.
Doctors know full well that, in the absence of objective signs, patients with persistent problems allegedly related to “whiplash” are psychologically inadequate. It may not altogether be their fault. Doctors are often to blame. As Andrew Malleson shows, there is any amount of bad medical science upon which these sad people rely. When we should be saying to people, “Well, yes, I am sure you have been a bit shaken up by the accident…” our computers encourage us to enter “whiplash” on the patient’s summary. We need to stop doing that. We need to reserve the diagnosis “whiplash injury” for patients who have Grade 3 and Grade 4 problems. It is not fair to those patients to lump them together with the malingerers and inadequates.
"Whiplash is a serious injury. Left untreated neck and back pain can often last a lifetime"
A man with a beard.
Or, mutatis mutandis, if you have a whiplash injury and do not give large sums of money to a chiropractor, you risk a life time of illness.
That is utter bollocks.
- John.Crippen's blog
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