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Precollision Medical Diagnoses Predict Chronic Neck Pain Following Acute Whiplash Trauma
Tine B Osterland1, Helge Kasch2, Lisbeth Frostholm1
1The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital.
The Clinical Journal of Pain
|March 5, 2019
Summary
Precollision pain and medically unexplained symptoms significantly increase the risk of developing chronic neck pain after whiplash trauma. These factors may indicate pre-existing vulnerabilities triggered by the injury.
Area of Science:
- Pain Medicine
- Traumatology
- Epidemiology
Background:
- Whiplash-associated disorder (WAD) development is poorly understood.
- Identifying pre-injury risk factors for chronic WAD is crucial for targeted interventions.
Purpose of the Study:
- To investigate the association between precollision pain-related diagnoses, medically unexplained symptoms, and psychiatric diagnoses with the development of WAD.
Main Methods:
- Prospective observational study of 719 whiplash-exposed individuals and 3595 matched controls.
- Data collected on precollision diagnoses (pain, medically unexplained symptoms, psychiatric) for 5 years prior.
- Neck pain assessed at 12 months postcollision using Visual Analog Scale.
Main Results:
- Whiplash-exposed cohort showed higher incidences of precollision pain-related diagnoses and medically unexplained symptoms.
- Precollision pain-related diagnoses (OR=2.46) and medically unexplained symptoms (OR=1.72) significantly predicted chronic neck pain at follow-up.
- No significant association found for precollision psychiatric diagnoses.
Conclusions:
- Precollision pain and medically unexplained symptoms are significant predictors of chronic neck pain after whiplash.
- These findings suggest pre-existing individual vulnerabilities or healthcare-seeking behaviors may contribute to chronic WAD.
- Whiplash trauma may act as a trigger for underlying predispositions to chronic pain.
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