How many people are injured each year in relatively low-speed rear impact collisions (LoSRICs)? You know the kind I am referring to -- the kind that the auto insurers and their medicolegal lackeys claim cannot produce injuries lasting more than a few weeks.
I've just finished writing the chapter on epidemiology in my forthcoming book, Understanding Low Speed Rear Impact Collisions. I thought the readers of DC might be interested in the very latest statistics on whiplash injuries, particularly since we have been bombarded this year with bad science: first the RAND-sponsored report on the high incidence of fraud in personal injury; then the "Scientific monograph of the Quebec Task Force on whiplash-associated disorders: redefining 'whiplash' and its management." I have previously addressed the RAND-sponsored and QTF reports in "DC" earlier this year. The report sponsored by RAND was seriously flawed. The QTF report is problematic in a number of ways. I address these in more detail my new book. However the QTF clearly did not "redefine whiplash" nor did they give us anything tangible in terms of management.
I reviewed data from a number of government sources, including the National Accident Sampling System; General Estimates System; Crashworthiness Data System; Fatal Accident Reporting System; National Highway and Traffic Safety Administration's special report on whiplash; National Safety Council; U.S. Public Health Service, and the Federal Highway Administration. From this data I have derived what I believe are the most accurate current figures for the incidence of whiplash (actual number of new injuries each year) and the prevalence of chronic residuals from whiplash injuries in the U.S. population. I did this several years ago, but it is such a tremendous headache that I resisted doing it again until just recently. The following is an excerpt from the summary section of chapter one of my new book:
FARS/GES
NSC
NHTSA Special Report
However, I have calculated that there are two million rear impact accident related injuries in the U.S. each year, giving us an incidence of 770/100,000. These accidents account for 38.7 percent of all motor vehicle accident injuries. Based on my calculations, the various estimating systems currently in place may be underestimating the problem of whiplash by more than 40 percent.
Most rear impact collisions occur during daylight hours; most happen during rush hour traffic, on straight, flat, dry sections of road. Driver inattention and recognition delays has been cited as the leading cause of rear impact collision (93 percent). Younger persons are more frequently involved as the drivers of the striking vehicle, with males and females equally represented in this role. However, females are significantly overrepresented in the struck driver role for reasons not entirely clear to me at this point.
Outcome/prognostic studies suggest that from 12 percent to 86 percent of whiplash victims will continue to be symptomatic for years after the injury. (Again, in the interest of brevity I've omitted much of these derivations.) Rear impact injuries have a worse prognosis than side or frontal impact injuries. On average about 46 percent of the patients in these studies had not recovered completely at follow-up -- about 10 percent rating their problems as disabling or severe. Using these outcome studies, in conjunction with the incidence figure derived earlier, I estimated the following prevalence figures:
a. Assuming a conservative 25 percent nonresolution of symptoms; after 25 cumulative years of whiplash, the prevalence of chronic pain in the U.S. would be 6,731/100,000, or 6.7 percent of the population.
b. Assuming 50 percent nonresolution of symptoms, after 25 cumulative years of whiplash; the prevalence of chronic pain in the U.S. would be a remarkable 9,615/100,000, or 9.6 percent of the population.
LoSRICs comprise a large proportion of all rear impact collision injuries. Most modern passenger vehicles can withstand crash speeds of up to eight or nine mph, and sometimes higher, without sustaining visible damage. The reported threshold for soft tissue injury of the neck in healthy adult males is five mph. Therefore, modern passenger vehicles can crash at nearly twice this injury threshold, yet appear undamaged. There is no scientific basis for estimating or calculating the probability of soft tissue injury to the occupants of vehicles based on property damage to the vehicles.
Finally, there are three ways that we can attempt to reduce the size of the problem:
a. Reduce the number of collisions through high technology crash avoidance countermeasures, such as the Intelligent Vehicle Highway System currently under research.
b. Make all passenger vehicles more crashworthy through the use of improved restraint systems, improved head restraints and seat backs, and enhanced bumper designs.
c. Improve treatment and management strategies through physician continuing education, particularly targeting portal of entry practitioners, such as emergency room physicians.
Arthur C. Croft
San Diego, California
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
