Tissue damage or pathological alterations are not detectable in the majority of people with whiplash associated disorders (WAD). Widespread hyperalgisa, morphological muscle changes and psychological distress are common features of WAD. However little is known about the presence of
inflammation and its association with symptom persistence or the clinical presentation of WAD. This study aimed to prospectively investigate changes in serum inflammatory
biomarker levels from the acute (<3 weeks) to chronic (>3 months) stages of
whiplash injury. It also aimed to determine relationships between
biomarker levels and
hyperalgesia, fatty muscle infiltrates of the cervical extensors identified on MRI and psychological factors. 40 volunteers with acute WAD and 18 healthy controls participated. Participants with WAD were classified at 3 months as recovered/mild disability or having moderate/severe disability using the Neck Disability Index. At baseline both WAD groups showed elevated serum levels of CRP but by 3 months levels remained elevated only in the moderate/severe group. The recovered/mild disability WAD group had higher levels of TNF-α at both time points than both the moderate/severe WAD group and healthy controls. There were no differences found in serum IL-1β. Moderate relationships were found between
hyperalgesia and CRP at both time points and between
hyperalgesia and IL-1β 3 months post injury. There was a moderate negative correlation between TNF-α and amount of fatty muscle infiltrate and
pain intensity at 3 months. Only a weak relationship was found between CRP and
pain catastrophising and no relationship between
biomarker levels and posttraumatic stress symptoms. The results of the study indicate that inflammatory
biomarkers may play a role in outcomes following
whiplash injury as well as being associated with
hyperalgesia and fatty muscle infiltrate in the cervical extensors.