Table 1

The Quebec Task Force on whiplash associated disorders (WAD) classification scheme

GradeInjury and SymptomsSigns
1Probable muscle sprain.No tenderness and normal range of motion
Neck stiffness onlyNormal reflexes and muscle strength in the limbs
2Probable muscle and/or ligament sprain.Paraspinal tenderness and restricted spine range of motion.
Any combination of neck pain with or without back pain, jaw pain, jaw locking, jaw clicking, limb, numbness, dizziness.Normal reflexes and muscle strength in the limbs.
3Probable disc protrusion with nerve root impingement.Abnormal reflexes and/or muscle weakness, often with sensory changes in a dermatomal pattern suggesting nerve root impingement (typically due to disc protrusion)
Neck pain, often arm pain or numbness.
4Cervical fracture and/or dislocationPossible hyperreflexia, positive Babinski’s sign, motor weakness and sensory changes suggesting spinal cord injury.
Neck pain, possibly neurological symptoms in limbs, urinary incontinence due to spinal cord involvement.
Radiograph reveals fracture and/or dislocation.