Ask the Experts: Whiplash Pain: Myth, Mechanism, and Misunderstanding - Podcast 21

In Episode 21, “Whiplash Pain: Myth, Mechanism, and Misunderstanding”, our experts examined whiplash-associated pain. Featuring leaders whose work has helped define the modern understanding of whiplash-associated disorders, the discussion explored key questions surrounding pain generators, diagnostic evaluation, treatment options, interventional management, and long-term outcomes.

• How do we determine the structural cause of whiplash pain?
• What research exists to determine the cause of whiplash pain?
• Is history alone sufficient to identify the whiplash pain generator?
• What role, if any, does the physical exam play in determining the whiplash pain generator?
• What treatments help with acute whiplash pain?
• What treatments help with chronic whiplash pain?
• What is the interventional pain management plan for acute and/or chronic whiplash pain?
• Is there a role for the biopsychosocial model in whiplash pain?
• What surgical options are available for whiplash pain, and when should they be considered?
• What are the treatment outcomes of cervical medial branch RF coagulation?
• Do any other treatment options have the same documented outcomes as cervical RF?
• What is the literature regarding subfailure capsular strain as a cause of chronic neck pain after whiplash?
• What literature is available regarding the anterior annulus fibrosus as a pain source?

Your expert panel for this August 6, 2026, webinar included:

• Nikolai Bogduk, MD, PhD — Emeritus Professor of Pain Medicine at the University of Newcastle, Australia, founding IPSIS member, and pioneer in the understanding of whiplash-associated disorders;
• Rodney Jones, MD — Interventional pain physician, Clinical Assistant Professor of Anesthesiology at the University of Kansas School of Medicine–Wichita, IPSIS Master Instructor, and member of the IPSIS Instructor Development Committee; and
• Michael Furman, MD, MS, Fellowship Director at OSS Health, who founded and moderates the Ask the Experts series, and serves on the IPSIS Education Division, and as a Bio-Skills Lab Master Instructor.

Episode 21 Show Notes: An Annotated Reading List for Whiplash

• Bogduk N. Whiplash injury. In: Cervero F, Jensen TS (eds). Handbook of Clinical Neurology, Volume 81: Pain. Elsevier, Amsterdam, 2006, pp. 791-801.  Includes a summary of studies of the biomechanics of whiplash and its natural history.
• Radanov BP, Sturzenegger M, Di Stefano G. Long-term outcome after whiplash injury. A 2-year follow-up considering features of injury mechanism and somatic, radiologic, and psychosocial findings. Medicine. 1995;74:281-297.  A responsible study of natural history in Switzerland, which shows that only 10% of patients continue to have severe pain.
• Bogduk N. On cervical zygapophysial joint pain after whiplash. Spine. 2011;36:S194-S199.  Describes convergent validity, i.e. how studies using totally different methods converge on the same conclusion: that the pain comes from the cervical Z joints.
• Bogduk N, MacVicar J. Subfailure capsule strain as the cause of cervical zygapophysial joint pain after whiplash: a scoping review. Pain Medicine. 2026;27:883-892.  A recent review that collates the literature that shows that subfailure injuries generate pain.
• Engel AJ, Bogduk N. Neck Pain. In: Ballantyne JC, Fishman SM, Rathmell JP (eds). Bonica’s Management of Pain, 5th Edn. Wolters Kluwer, Philadelphia, 2019, pp. 1230-1244.  Summarises the literature on the treatment of acute and chronic neck pain.
• Bogduk N, MacVicar J. Osteoarthritis of zygapophysial joints as a cause of back pain and neck pain: a scoping review. Pain Medicine. 2024;25:541-552.  The evidence that osteoarthritis of cervical Z joints does not cause neck pain.
• Govind J, Bogduk N. Sources of cervicogenic headache among the upper cervical synovial joints. Pain Medicine. 2022;23:1059-1065.  Describes the algorithm and yield of diagnostic blocks in patients with neck pain and in whom headache is or is not the dominant symptom.
• Bogduk N. On understanding the validity of diagnostic tests. Interventional Pain Medicine. 2022;1:100127. Bogduk N. On the validity and clinical utility of comparative local anesthetic blocks for the diagnosis of spine pain. Interventional Pain Medicine. 2023;2(2):100257.  Teaching articles that explain how the validity of diagnostic blocks is measured and applied into clinical practice.
• Engel A, King W, Schneider BJ, Duszynski B, Bogduk N. The effectiveness of cervical medial branch thermal radiofrequency neurotomy stratified by selection criteria: a systematic review of the literature. Pain Medicine. 2020;21:2726-2737.  A comprehensive review of the evidence on effectiveness of RF coagulation of cervical medial branches, which shows that success rates for various grades of outcomes are related to how stringent are the criteria used for positive responses to diagnostic blocks.

Watch the “Whiplash Pain: Myth, Mechanism, and Misunderstanding ” webinar where this podcast was recorded. A streaming Ask the Experts video is available here.

© 2026 International Pain and Spine Intervention Society – All Rights Reserved Materials presented in this activity have been made available by the International Pain and Spine Intervention Society for educational purposes only.