Factors influencing recovery from headache after common whiplash
B P Radanov1, M Sturzenegger, G Di Stefano
1Department of Psychiatry, University of Berne, Switzerland.
Objective:
To assess the relation between pretraumatic and trauma related headache in patients suffering from whiplash.
Design:
Follow up study of patients examined a mean (SD) of 7.4 (4.2) days after trauma and again at three and six months.
Setting:
Patients referred from primary care.
Subjects:
117 patients (mean age 30.8 (9.5) years.
Main Outcome Measures:
Prevalence of trauma related headache and the predictive relation by multiple logistic regression between different somatic and psychological variables and trauma related headache at each examination.
Results:
Prevalence of trauma related headache decreased from 57% to 27%. History of pretraumatic headache proved a significant risk factor for presenting with trauma related headache. A significant relation between trauma related headache and the following variables was found: at seven days the initial wellbeing score, early onset of neck pain, depression scale from the personality inventory, and the initial intensity of neck pain; at three months, intensity of neck pain, and history of pretraumatic headache; and at six months neck pain, pain intensity, and history of pretraumatic headache.
Conclusions:
History of pretraumatic headache significantly increases the likelihood of presenting with trauma related headache but only in combination with findings indicative of clinically important injury to the cervical spine.
