• Gwendolen A Jull, Anne Söderlund, Brian D Stemper, Justin Kenardy, Anita R Gross, Pierre Côté, Julia Treleaven, Nikolai Bogduk, Michele Sterling, and Michele Curatolo.
• CCRE Spinal Pain, Injury, and Health, Division of Physiotherapy, The University of Queensland, Australia. g.jull@uq.edu.au
• Spine. 2011 Dec 1;36(25 Suppl):S335-42.

Study DesignExpert debate and synthesis of research to inform future management approaches for acute whiplash disorders.ObjectiveTo identify a research agenda toward improving outcomes for acute whiplash-injured individuals to lessen the incidence of transition to chronicity.Summary Of Background DataInternational figures are concordant, estimating that 50% of individuals recover from pain and disability within 3 to 6 months of a whiplash injury. The remainder report continuing symptoms up to 1 to 2 years or longer postinjury. As no management approach to date has improved recovery rates, new clinical/research directions are required for early management of whiplash-injured patients.MethodsA group of multidisciplinary researchers critically debated evidence and current research concerning whiplash from biological, psychological, and social perspectives toward informing future research directions for management of acute whiplash.ResultsIt was recognized that effective treatments for acute whiplash are constrained by a limited understanding of causes of whiplash-associated disorders. Acute whiplash presentations are heterogeneous leading to the proposal that a research priority was development of a triage system based on modifiable prognostic indicators and clinical features to better inform individualized early management decisions. Other priorities identified included researching effective early pain management for individuals presenting with moderate to high levels of pain; development of best education/information for acute whiplash; testing the efficacy of stratified and individualized rehabilitation, researching modes of delivery considering psychosocial modulators of pain and disability; and the timing, nature, and mode of delivery of cognitive-behavioral therapies. Directions were highlighted for future biomechanical research into injury prevention.ConclusionThe burden of whiplash injuries, the high rate of transition to chronicity, and evidence of limited effects of current management on transition rates demand new directions in evaluation and management. Several directions have been proposed for future research, which reflect the potential multifaceted dimensions of an acute whiplash disorder.

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