Dozens of studies over the last few years have shown us that most chronic pain from auto injuries is a result of injury to the ligaments of the spine. These injuries most often occur in the facet capsular ligaments, but studies have also shown injury to the anterior and posterior longitudinal ligament and the alar ligament.
It’s a common misconception that whiplash injuries—even those involving ligament trauma—are self-limiting. Even though clinical experience and the medical literature make it clear that a significant group of whiplash patients have chronic pain, the conventional wisdom is that the patient should be completely recovered in a few months. This idea is based on the myth that ligament injuries heal in about six weeks.
A recent review in the American Journal of Medicine explodes that myth. In this article, researchers looked at 24 high-quality studies that examined the natural course of recovery from ankle sprain. They found the following:
- There was a rapid decrease in pain levels in the patients during the first two weeks.
- The studies reported a wide range of pain levels at one year: from 5-33%.
- Many patients reported problems three years after the injury. In one study, up to 15% of patients complained of problems at three years.
This study is important, because it demonstrates that ligament injuries that (most likely) have no involvement in litigation can result in chronic issues for the patient. If 15% of patients with ankle sprains report symptoms three years later, it shouldn’t be surprising that patients with neck sprains would also have symptoms many years after their whiplash injury.
- Van Rign RM, van Os AG, Bernsen RMD, et al. What is the clinical course of acute ankle sprains? A systematic literature review. The American Journal of Medicine, 2008;121(4):324-331.