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Shaw Chiropractic
A Medical-Legal Newsletter for Personal Injury Attorneys
by Dr. Steven W. Shaw

New Research on "Late Whiplash" Syndrome"

Some of you may recall the study from Lithuania several years ago which had been used quite successfully to refute the claims of your clients who had residual neck pain. It had become so popular in the defense world that it was commonly known as "The Lithuania Study". After several years of effort the scientific community was successful in pointing out the flaws of the original study to the point where the defense bar has discontinued it’s use

Now the same researchers have published a follow-up study attempting to further refine their research and to correct any errors. Enclosed you will find a copy of the new "Lithuania Study". The study is titled "Pain after whiplash: a prospective controlled inception cohort". The paper was authored by Obelieniene, Schrader, Bovim, Miseviciene and Sand and published in the Journal of Neurology, Neurosurgery and Psychiatry in January 1999. This new study has rekindled the controversy over the so-called "late whiplash syndrome. In fact, this study questions the mere existence of the syndrome as a direct consequence of rear-end collisions. This newsletter will review the salient points which you must be familiar with to argue your client’s case from an informed position.

This new prospective study selected 210 victims (181 men and 29 women) of rear-end collisions in Lithuania. An average of 11 days post trauma a questionnaire was mailed to the victims regarding neck pain and headache only. The questionnaire was mailed again at 2 months and again at 1 year. Initial pain was reported by 47% of accident victims (10 neck pain, 18% neck pain and headache, 19% headache alone). The victims were age and sex matched to a control group of randomly assigned Lithuanian citizens in the same geographic area.

Despite the large number of people with pain the mean duration of the pain was 3 days with the longest duration being 17 days. The authors defined chronic pain based upon frequency and duration. Frequent neck pain was defined as symptoms which existed more than seven days per month. After reviewing the results of the 1 year survey the following was reported: Neck pain was reported by 4% of the victims and 6.2% of the controls. Self assessed neck mobility was reduced by 12% in the accident victims and 18% among controls. The authors conclude that the incidence of chronic neck pain in their study is consistent with other researcher findings. They also suggest that chronic neck pain from rear-end collisions is no different than that in the general public. They support their findings by citing agreement between their findings and those from other researchers in experimental settings.

You can be sure that the defense community is preparing this data for presentation at trial. In fact, I’m surprised that we haven’t seen it used yet in settlement negotiations. What can you do if and when you are confronted with this data? READ ON AND BE PREPARED!!! First, review the paper from cover to cover and make sure your medical expert is at least familiar with it. Second, make sure that you bring up the following arguments.