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bibliography * The PainScience Bibliography contains plain language summaries of thousands of scientific papers and others sources, like a specialized blog. This page is about a single scientific paper in the bibliography, Atherton 2006.

Predictors of persistent neck pain after whiplash injury

updated
Atherton K, Wiles NJ, Lecky FE, Hawes SJ, Silman AJ, Macfarlane GJ, Jones GT. Predictors of persistent neck pain after whiplash injury. Emerg Med J. 2006 Mar;23(3):195–201. PubMed #16498156.
Tags: etiology, mind, prog, neck, back pain, pro, head/neck, spine, pain problems

PainSci summary of Atherton 2006?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★★★☆?4-star ratings are for bigger/better studies and reviews published in more prestigious journals, with only quibbles. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.

480 people with neck pain after car accidents completed questionnaires three times during the year after their accident. 128 (27%) reported neck pain every time. “The greatest predictors of persistent neck pain … relate to psychological distress and aspects of pre-collision health rather than to various attributes of the collision itself.” In other words, people who went into the accident with the most stress and body pain were the most likely to suffer chronic neck pain. For a short article discussing this research, see A Recipe for Chronic Neck Pain After Whiplash.

The findings are generally confirmed by more research since. See Carstensen.

~ Paul Ingraham

original abstractAbstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

OBJECTIVE: To establish the aetiological influences of persistent neck pain following a motor vehicle collision and to construct a model for use in the emergency department for identifying patients at high risk of persistent symptoms.

DESIGN: Prospective cohort study. Patients recruited from hospital emergency departments were sent a questionnaire to gather information on various exposures. They were followed up at 1, 3, and 12 months to identify those with persistent symptoms.

MAIN OUTCOME MEASURE: Persistent neck pain (pain at 1, 3, and 12 months after collision).

RESULTS: The baseline survey included 765 patients. Subsequently, 480 completed a questionnaire at each follow up time point, of whom 128 (27%) reported neck pain on each occasion. Few collision specific factors predicted persistent neck pain. In contrast, a high level of general psychological distress, pre-collision history of widespread body pain, type of vehicle, whiplash associated symptoms, and initial neck disability best predicted the persistence of symptoms. Furthermore, these factors, in combination, accounted for more than a fivefold increase in the risk of persistent neck pain.

CONCLUSION: The greatest predictors of persistent neck pain following a motor vehicle collision relate to psychological distress and aspects of pre-collision health rather than to various attributes of the collision itself. With these factors, and those relating to initial injury severity, it is possible to identify a subgroup of patients presenting with neck pain with the highest risk of persistent symptoms. Thus, it is possible to identify whiplash patients with a poor prognosis and to provide closer follow up and specific attention to management in these individuals.

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