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Chronic posttraumatic syndrome after whiplash injury. A pilot study of 22 patients.

Chronic posttraumatic syndrome after whiplash injury presents several problems to the general practitioner, due largely to the discrepancy between the multiplicity of subjective symptoms and the poverty of objective findings. With the aim of analysing the symptoms and signs of this syndrome and of evaluating the significance of extended physical examination, 22 chronically disabled patients were investigated. The chronic syndrome is characterized by widespread symptoms, migrainous headache, and aggravation following physical activity. Extended physical examination, including an analysis of pain reaction elicited by palpation and a nerve tension test of the brachial plexus, together with negative X-ray examination, supports a common origin of symptoms in soft tissue injury and a disturbance of locomotor function. On the basis of this study we propose an alternative approach to diagnosis and care for these patients.