Neck Pain in “Minor” Traffic Accidents
There seems to be continued discussion regarding the factors that need to be present in order to predict whether an injured victim will develop chronic pain. In a study by Pape, Brox, Hagen, Natvig, and Schirmer (2007), certain “factors” were identified that may lead to chronic neck pain in an injured population of 636 people with minor or moderate traffic injuries. The authors stated in the research paper, “Daily severe or very severe neck pain at three years follow up was defined as chronic neck pain” (p. 135).
The authors stated in the introductory portion of the paper, “In the systematic review of the literature on whiplash published by the Quebec Task Force in 1995 (Spitzer et al., 1995) it was concluded that the symptoms are self-limited with favourable prognosis for most patients. However, the authors found that the scientific quality of the prognostic studies was poor and that it was impossible to make evidence-based recommendations on prognostic factors for recovery (Spitzer et al., 1995)” (Page et al., 2007, p. 135).
This is important because is correlates with the mindsets of many clinicians that work with the traumatically injured, in that each person’s symptoms and objective findings are just that, individual. Rendering an individual diagnosis, prognosis and correlating bodily injury to persistent functional loss needs to be done on an individual basis. Researchers’ desires to place people into categories or groups continue to be ineffective. Each person responds to the accident and care differently. In this paper published 12 years after the Quebec Task Force paper, there were factors that were identified that can help to determine who is most likely to have continued pain 3 years post injury. It happens more frequently than many doctors realize.
These authors showed that there are factors that have been able to predict who will develop chronic neck pain following a whiplash injury. They state, “The present study identified eight significant independent prognostic factors for chronic neck pain after traffic accidents. These comprised neck and/or shoulder pain before the accident, the impact of the collision, early post-accident bodily tension and impaired cognitive and physical function, as well as pessimism for the future ability to work” (Page et al., 2007, p. 140). The details of the accident mechanism are critical, as are taking a good past medical and current history. Doctors that understand how to identify these factors and properly report them are crucial for establishing a proper diagnosis and management of functional loss due to whiplash injury.
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Reference:
Pape, E., Brox, J. I., Hagen, K. B., Natvig, B., & Schirmer, H.(2007). Prognostic factors for chronic neck pain in persons with minor or moderate injuries in traffic accidents. Accident Analysis & Prevention,39(1), 135-146.
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