• A A Vendrig, P F van Akkerveeken, and K R McWhorter.
• Rug AdviesCentra Nederland, Zeist, The Netherlands. vendrig@rac-zeist.nl
• Spine. 2000 Jan 15;25(2):238-44.

Study DesignA descriptive case series pre- and post-treatment design, including a 6-month follow-up.ObjectivesThe objective of this study was to document the improvements of patients with chronic symptoms after a "whiplash" injury of the neck, who attended a 4-week multimodal treatment program at the Rug AdviesCentra Nederland.Summary Of Background DataTo the authors' knowledge, no studies have been conducted on the effectiveness of multidisciplinary treatment of chronic symptoms after whiplash injury.MethodsTwenty-six patients who experienced Quebec type 1 or 2 lesions of the neck (whiplash) with persisting symptoms of longer than 6 months' duration participated in the study. The measures included were pain intensity (according to the visual analog scale), number of painful sites (determined by pain drawing), self-reported disability Quebec Back Pain Disability Scale; and symptoms of somatic and psychological distress and cognitive symptoms (according to selected Minnesota Multiphasic Personality Inventory-2 scales). Furthermore, objective outcome criteria were used regarding return to work, medication, and medical and paramedical treatment. Statistical and clinical significance of treatment results were both assessed.ResultsThe patients' symptoms improved significantly on nearly all self-report measures. Their scores for objective outcome criteria reported during the 6-month follow-up evaluation were: complete return to work (65%); complete or partial return to work (92%); no use of analgesics in the past 6 months (58%); and no medical or paramedical treatments in the past 6 months (81%).ConclusionThese early results indicate that a multimodal treatment program has the potential to be an effective treatment for patients with chronic symptoms after a whiplash injury of the neck--a group of patients who have in the past been considered intractable or, at the very least, puzzling.

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