De term ‘whiplash’ liever vermijden

Commentaar op de multidisciplinaire richtlijn voor ongecompliceerde whiplash
Jan Buitenhuis en Peter J. de Jong

Avoid the term ‘whiplash’. Commentary on the multidisciplinary guideline on uncomplicated whiplash

In the evidence based guideline ‘Diagnosis and treatment of people with whiplash associated disorder I or II’ active treatment is advised. On the basis of recent research we argue that the diagnostic label ‘whiplash’ should be avoided. Research on low back pain, somatoform disorders and chronic fatigue syndrome showed that catastrophizing and causal beliefs are related to perceived disability and poor prognosis. Similarly, patients indicating negative expectations regarding recovery from neck pain after an accident, showed a poor prognosis. Attributing initial neck complaints to whiplash predicted the persistence of disability, regardless of the severity of the initial complaints. Thus, using the term whiplash as a diagnostic label may contribute to neck pain becoming chronic. Physicians should be aware of this. They should pay attention to the thoughts of the patients regarding the causes and origin of the complaints. Particularly during the early stage, cognitive guidance could possibly prevent the course from becoming chronic.