PTSD Linked to Severe Whiplash

Post traumatic stress disorder can raise your risk of suffering from severe symptoms after whiplash, according to new research.

A new study found that 25.7% of whiplash patients suffered from posttraumatic stress disorder which negatively influenced their physical symptoms.

Earlier research has suggested that PTSD and hypersensitivity to pain may increase the likelihood that a patient develops chronic symptoms after whiplash. However it is still unclear how psychological symptoms impact patients' experiences with pain and disability. Additionally, whiplash associated disorders encompass a broad range of symptoms, and not all patients suffer from hypersensitivity or PTSD.

Ashley Pedler and Michele Sterling of the University of Queensland in Australia recently conducted a study to see whether whiplash patients could be categorized based on PTSD and hypersensitivity symptoms. Their study included 331 patients who had sustained a whiplash injury within the previous 3 months from a motor vehicle collision. Patients were evaluated for neck pain, disability, cervical range of motion, mental health, and PTSD. They were also tested for hypersensitivity using pressure pain and cold pain threshold tests.

Researchers found that 43.5% of patients did not suffer from either PTSD or hypersensitivity, despite the fact they experienced disability and pain. People that did have moderate to severe PTSD and hypersensitivity had significantly worse neck pain and disability scores. These patients also tended to be older than the no PTSD/no hypersensitivity group.

Having hypersensitivity alone did not affect physical symptom severity however, while having PTSD alone was tied to worse disability and pain. This suggests that "although the processes underlying PTSD and sensory hyperalgesia may be related, hypersensitivity can be present independently of PTSD."

A quarter of patients in this sample showed signs of posttraumatic stress, suggesting they could benefit from PTSD management. Previous research has demonstrated that cognitive behavioral therapy can influence both the physical and psychological outcomes of chronic whiplash.

These findings show how important it is to address the whole person, both the psychological and the physical symptoms, when treating patients recovering from WAD. Reducing disability and pain can help to decrease anxiety and stress, which may then in turn help to further decrease disability and pain. Chiropractic care can help to begin this process by successfully alleviating the physical symptoms of whiplash, in addition to assisting with stress reduction.


Pedler A and Sterling M. Patients with chronic whiplash can be subgrouped on the basis of symptoms of sensory hypersensitivity and posttraumatic stress. PAIN 2013; pii: S0304-3959(13)00228-5. doi: 10.1016/j.pain.2013.05.005.