A study looking at different names for neck pain experienced after a motor vehicle crash – commonly referred to as whiplash – has suggested that using different names may result in different patient expectations about recovery and management strategies. 

Published in November 2025 in the journal Musculoskeletal Science and Practice, the research found that how clinicians label people’s injuries after a car crash can shape their perceptions of the injury as well as their expectations for treatment and recovery. 

The research was conducted by Dr Yanfei Xie, a physiotherapist and researcher in Professor Michele Sterling’s research team at the University of Queensland’s RECOVER Injury Research Centre and a lecturer at Charles Sturt University. 

Yanfei conducted an online randomised controlled study to compare different labels for neck pain: ‘whiplash injury’, ‘whiplash-associated disorder’, ‘post-traumatic neck pain’, ‘neck strain’ and ‘neck pain’. 

In the study, more than 2200 participants – who were split into two groups, one with a history of neck pain and one without – were asked to imagine being a patient presenting to the emergency room after a car crash. 

In this hypothetical scenario, the initial assessment, including an X-ray, did not find a major injury. 

Two weeks later, however, the patient was still experiencing neck pain and visited their primary healthcare provider. 

After examining the patient, the healthcare provider gave them one of the five diagnostic labels, saying the injury was not serious and that returning to daily activities as best as possible was important.

Participants in the study then provided feedback on what the diagnostic label meant to them, how it made them feel, what treatments they thought they might need based on the label and whether the diagnosis was confusing. 

The researchers analysed participants’ responses using content analysis (a structured approach that examines both themes and how often they occur), finding that the labels did influence beliefs and feelings about the diagnosis and management expectations. 

Of participants assigned to the label ‘neck strain’, 18 per cent felt that the condition was minor and they were likely to recover well, compared to those assigned to ‘post-traumatic neck pain’ (seven per cent) or ‘neck pain’ (three per cent). 

Negative expectations about symptom severity and prognosis were least common among participants assigned to ‘neck strain’ (five per cent) but more frequent among those assigned to ‘post-traumatic neck pain’ (16 per cent) and ‘whiplash-associated disorder’ (10 per cent). 

Psychological distress was least linked to ‘neck strain’ (seven per cent) compared to ‘post-traumatic neck pain’ (30 per cent), ‘neck pain’ (14 per cent) and ‘whiplashassociated disorder’ (13 per cent).

Participants assigned to the label ‘neck strain’ (12 per cent) most often expressed a need for exercise, whereas participants assigned to the label ‘neck pain’ (five per cent) expressed this need least frequently. 

‘Among the five labels tested, “neck strain” seemed to be associated with more favourable beliefs. However, about 10 per cent of the participants also felt that the label was a bit vague and inaccurate,’ Yanfei says. 

Around 40 per cent of participants who were given the diagnosis of ‘neck pain’ felt that the label was confusing. 

This was largely because they perceived that the label was vague and overly broad, which made them more likely to seek a second opinion. 

This was especially true for participants with personal experience of neck pain. 

‘The participants already knew they had neck pain so when they received this label, they felt like the healthcare provider knew nothing about it; it was a backup label that was thrown to them because the provider had no idea what was going on.’ 

On the other hand, patients given the labels ‘whiplash-associated disorder’ or ‘post-traumatic neck pain’ were more likely to think about psychological and long-term issues. 

‘Many patients link terms like “disorder” and “post-traumatic” to post-traumatic stress disorder – it’s not actually the word “whiplash” that made people think their injury was worse.’ 

The study suggests that the choice of diagnostic label can affect both the perception of the injury severity and expectations of management and recovery. 

Yanfei says the key take-home message is that healthcare providers need to ensure their patient understands the diagnosis and what it means and, if necessary, to provide a comprehensive explanation of management and prognosis based on recommended guidelines or best practice approaches to care. 

‘These are small things that clinicians can easily do in their practice – be mindful of the language they use and take the time to explain diagnostic labels to patients in a reassuring way. 

We should check the patient’s reaction to the label and their understanding of what management and recovery look like. 

If a patient shows negative reactions to the label (eg, fear, unhelpful beliefs), then we should intervene at that time to correct their misconceptions.’