The onset of pain
- Many clinical, automotive, and epidemiologic studies report frequent delays in patients having symptoms following an automobile collision event.
- Although there are many factors as to why symptom onset delay occurs, one major factor is believed to be related to the spreading of posttraumatic edema (1).
- Cailliet concluded that it is not unusual for upper extremity pain or paresthesias to become symptomatic or problematic 2 to 4 months after a motor vehicle collision (2).
How long does whiplash last?
- Hemorrhagic phase up to one week (3)
- Inflammatory phase up to two weeks (3)
- Proliferative phase up to seven weeks (3)
- Remodeling phase up to 12 months (3).
- Carlstedt’s review of the literature concludes that the remodeling stage peeks at 3 to 4 weeks and continues up to about one year (4).
- The Québec task force concluded that this (remodeling) process takes about one year based from their analysis of medical literature (5).
When do injury symptoms reach maximum medical improvement (MMI)?
- Patients will experience most of the symptom improvement within 3 to 6 months after injury and then will taper off with a slower, gradual lessening of symptoms until their conditions stabilize at about six months to a year.
- Bannister and Gargan concluded from their review of the literature “that the vast majority of patients reach their final state within a year.” (6).