Pain after whiplash: a prospective controlled inception cohort study

Area of Science:

• Orthopedics
• Neurology
• Public Health

Background:

• Whiplash injury from rear-end collisions is often associated with chronic pain, a concept not widely recognized in Lithuania.
• This lack of awareness presents an opportunity to study post-traumatic pain without confounding factors common in Western societies.

Purpose of the Study:

• To investigate the incidence and duration of neck pain and headache following rear-end collisions in a population with no preconceived notions of chronic whiplash.
• To determine if acute whiplash injuries evolve into chronic pain or the late whiplash syndrome.

Main Methods:

• A prospective, controlled inception cohort study involving 210 rear-end collision victims identified via traffic police records.
• Neck pain and headache were assessed using mailed questionnaires at baseline, 2 months, and 1 year.
• A control group of 210 age- and sex-matched individuals from the same geographical area were also assessed for these symptoms.

Main Results:

• 47% of accident victims reported initial pain, with neck pain (alone or with headache) and headache alone reported by 28% and 19% respectively.
• Median duration for neck pain was 3 days (max 17 days), and for headache was 4.5 hours (max 20 days).
• After 1 year, no significant differences in symptom frequency or intensity were observed between accident victims and the control group.

Conclusions:

• In a setting without a pre-existing belief in chronic whiplash pain, symptoms following acute injury are self-limiting and brief.
• These findings suggest that acute whiplash injuries, under such conditions, do not typically develop into the late whiplash syndrome.