As editors of biomedical journals that focus on musculoskeletal pain and injury, we read first with interest and then growing concern the recent publication by Côté et al1 regarding patterns of initial treatment and resulting recovery rates for whiplash injury in Saskatchewan.1 These authors have concluded that, because patients who are initially treated more frequently by chiropractors and general practitioners go on to have longer recoveries than those who are treated less frequently, the cause of the prolonged recovery is the treatment. Not once in this article did the authors mention the common sense conclusion that patients with more severe injuries tend to both receive treatment more frequently initially and take longer to recover from their injuries. The authors' conclusion that treatment for a painful injury prolongs the duration of the injury is unsupported beyond the misinterpretation of their data and possibly by misrepresentation of their results.
Freeman MD, Centeno CJ, Merskey H, Teasell R, Rossignol A. Greater Injury Leads to More Treatment for Whiplash: No Surprises Here. Arch Intern Med. 2006;166(11):1238-1239. doi:10.1001/archinte.166.11.1238