大部分简单颈部疼痛的患者几天或几周后可完全恢复。小部分(约25%-30%)患者则会存在持续症状,常常会存在某些特定的病理改变(例如椎间盘突出)。车祸伤中颈部损伤往往是以后颈部疼痛的危险因素。[38]Nolet PS, Côté P, Cassidy JD, et al. The association between a lifetime history of a neck injury in a motor vehicle collision and future neck pain: a population-based cohort study. Eur Spine J. 2010;19:972-981.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2899973/http://www.ncbi.nlm.nih.gov/pubmed/20213298?tool=bestpractice.com之前存在挥鞭损伤的患者再次发生颈部损伤时,其预后往往较差。[16]Khan S, Bannister G, Gargan M, et al. Prognosis following a second whiplash injury. Injury. 2000;31:249-251.http://www.ncbi.nlm.nih.gov/pubmed/10719104?tool=bestpractice.com恢复情况的差异往往较大,很难判断哪些患者会在损伤后3个月内可以恢复。[39]Tomlinson PJ, Gargan MF, Bannister GC. The fluctuation in recovery following whiplash injury 7.5-year prospective review. Injury. 2005;36:758-761.http://www.ncbi.nlm.nih.gov/pubmed/15910829?tool=bestpractice.com针对颈部挥鞭损伤目前还没有有效的评估公式或方法来判断其不良预后,[40]Daenen L, Nijs J, Raadsen B, et al. Cervical motor dysfunction and its predictive value for long-term recovery in patients with acute whiplash-associated disorders: a systematic review. J Rehabil Med. 2013;45:113-122.http://www.medicaljournals.se/jrm/content/?doi=10.2340/16501977-1091&html=1http://www.ncbi.nlm.nih.gov/pubmed/23307298?tool=bestpractice.com虽然有一些症状,如上肢神经根放射症状和早期全身痛觉减弱(中枢神经系统痛觉感受器损伤表现)会提示可能会有持续的颈部疼痛。[41]Karnezis IA, Drosos GI, Kazakos KI. Factors affecting the timing of recovery from whiplash neck injuries: study of a cohort of 134 patients pursuing litigation. Arch Orthop Trauma Surg. 2007;127:633-636.http://www.ncbi.nlm.nih.gov/pubmed/17487496?tool=bestpractice.com[42]Sterling M, Jull G, Vicenzino B, et al. Sensory hypersensitivity occurs soon after whiplash injury and is associated with poor recovery. Pain. 2003;104:509-517.http://www.ncbi.nlm.nih.gov/pubmed/12927623?tool=bestpractice.com