Whiplash-Associated Disorder (WAD) is classified as a special case of acute or subacute pain in the neck that results from acceleration/deceleration transfer of energy. Typically, WAD involves multiple pain generators, including myofascial, ligamentous, discogenic and facet joint sources. Rear-end motor vehicle crashes and diving injuries are the most common causes of WAD. Each year in the United States, there are approximately one million cases of WAD resulting from motor vehicle accidents. Prognostic data is largely inconsistent, however, one of the larger studies observed the resolution of 60 percent of patient symptoms within just one month. The prevalence of chronic symptoms following acute onset of WAD is even less clear. WAD chronicity remains the subject of a lively medical debate because most patients do not have any readily identifiable injury in either the acute or chronic stage.
Presenting signs of WAD typically include pain or soreness in the posterior paramedian neck muscles with radiation to the occiput, shoulder or parascapular region. Also quite common are stiffness in one or more directions of motion and headache. Local warmth or tingling as well as localized areas of muscle tenderness (trigger points) may also be encountered. Initially, a very common secondary symptom is headaches, and often such symptoms are interpreted and treated as migraines without success.