Does physical trauma lead to an increase in the risk of new onset widespread pain?
OBJECTIVE
To determine the rate of new onset of widespread pain after a traumatic event (motor vehicle crash).


METHODS
A prospective cohort study of persons registered with an insurance company who had or had not experienced a motor vehicle crash. All participants were sent a questionnaire to assess pre-crash (or for the non-crash group, prior) psychosocial factors and widespread pain. Participants reporting pre-crash (prior) widespread pain were excluded. At six months, participants were sent a follow up questionnaire to ascertain new prevalent widespread pain.


RESULTS
597 (51%) of participants returned a baseline questionnaire (465 crash and 132 non-crash). Among the cohort who had experienced a crash, the new onset rate of widespread pain six months later was low (8%), though in comparison with the non-crash group there was an increased risk (RR = 1.9 (95% CI, 0.8 to 4.8, adjusted for age and sex)); this was attenuated after adjustment for pre-crash (prior) psychological distress and somatic symptoms (RR = 1.4 (95% CI, 0.5 to 3.2)).


CONCLUSIONS
The findings suggest that a motor vehicle crash (as an example of a physically traumatic event) is unlikely to have a major impact on the new onset of widespread pain. Any observed relation may, in part, be explained by psychological distress.
Wynne-Jones
G
G
Epidemiology Group, Department of Public Health, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, UK. gareth.jones@abdn.ac.uk
Macfarlane
G J
GJ
Silman
A J
AJ
Jones
G T
GT
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods; D012737:Sex Factors; D013315:Stress, Psychological / Q000150:complications; D014947:Wounds and Injuries / Q000150:complications*