A Greek with Whiplash...

Partheni M, Miliaras G, Constantoyannis C, Papadakis N.
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Whiplash injury.J Rheumatol. 1999 May;26(5):1206-7; author reply 1208-10. No abstract available. PMID: 10332996 [PubMed - indexed for MEDLINE]

In 1999, a paper was published by Partheni presuming to show that chronic whiplash injury didn't exist in Greece. This paper was widely criticized in the research community because it had poor methodology. The problem was that it failed to send questionnaires to enough Greeks to find cases of chronic whiplash. It was followed up with numerous papers that again seemed to be following on this same concept.

When George showed up in my clinic in 2003, I had a big chuckle. He was a Greek with chronic whiplash who had traveled thousands of miles for care here in the US. His work-up eventually showed upper cervical instability and objective MRI changes in the alar ligaments. He had a VNG in Greece showing severe abnormal nystagmus and his Smooth Pursuit Neck Torsion Test (SPNT) performed here by our clinic was grossly abnormal. So not only was there chronic whiplash in Greece, it can be objectified just as it can be here in the US, in Australia, or any other country. The Greek literature barrage was busted.

When you speak with George, it becomes clear why whiplash is not identified in Greece. George's family clearly has means. The medical system in Greece completely misidentified his injury. It wasn't until he bought his way to see some of the best specialists in the country that he met an ENT physician who was able to give him a diagnosis. So the problem isn't that whiplash doesn't exist in Greece or Lithuania, it's that poor nationalized health care systems strained with taking care of life threatening illnesses can't spend the resources to worry about traumatic neck pain. If you have money in those poor countries, you can get your whiplash diagnosed and handled. If you don't, you're at the mercy of an underfunded and overworked system.