Though most patients with a whiplash injury improve within a few months, about 25% have long-term pain and disability that may persist for many months or years.

Now, a team of scientists from Northwestern Medicine Feinberg school of Medicine reports that it may be possible to determine which whiplash patients will develop chronic pain, disability, and/or post-traumatic stress disorder (PTSD) within one to two weeks of their injury—leading to specialized treatment that may reduce their risk for developing a chronic condition.

Using a specialized form of MRI that measures the fat and water ratio in the neck muscles, the researchers found that greater fat infiltration into these muscles indicated rapid muscle atrophy. The presence of fat in the muscle is not related to the person’s weight, size, or shape and is believed to represent an injury that is more severe or serious than what might be expected from a typical low-speed car crash.

However, though the lead investigator notes that the fat infiltration into the muscle appears to be a response to an injury, what has actually been injured—muscle, nerves/spinal cord, and/or more—remains a mystery.

Another study by the same research team found that chronic pain whiplash victims also exhibited a high level of muscle fat in their legs—indicating atrophy. The researchers hypothesize that these patients may have partially damaged their spinal cord, as this group of patients also reported feeling weak and clumsy when walking.

Current research indicates that when managing whiplash cases, early return to activity, movement restoration, and exercises that specifically target the deep neck flexors lead to better outcomes than a “wait and watch” approach.

Doctors of chiropractic also utilize manipulation, mobilization, exercise training, diet, and nutrition, and encourage a return to a normal lifestyle as quickly as possible when treating patients with a whiplash injury.