Factors influencing neck pain intensity in whiplash-associated disorders.
METHODS
Cohort study of subjects with whiplash-associated disorders (WAD).


OBJECTIVE
To assess the association between preinjury factors and neck pain intensity within 30 days after a motor vehicle collision.


BACKGROUND
Neck pain is the main symptom in WAD. There are studies of nonspecific musculoskeletal pain suggesting that pain intensity can be modified by psychologic, personal, or social factors, but, to our knowledge, no studies have investigated the association between such factors and neck pain intensity in WAD.


METHODS
The subjects (n = 5970) either filed a claim or were treated for neck pain within 30 days after a collision. Neck pain intensity was measured on the visual analog scale.


RESULTS
Fair or poor health before the collision was associated with severe neck pain in females (odds ratio 4.0, 95% confidence interval 1.8-8.9). Other associated factors in females included low education and prior neck pain. Low family income was associated with severe neck pain in males (odds ratio 2.3, 95% confidence interval 1.5-3.4), as was prior headache and being unaware of the head position at the time of collision.


CONCLUSIONS
The results suggest that neck pain intensity in WAD seems to be influenced by several factors other than characteristics related to the injury event itself.
Holm
Lena W
LW
Institute of Environmental Medicine, Division of Epidemiology, Karolinska Institutet, Stockholm, Sweden. Lena.Holm@ki.se
Carroll
Linda J
LJ
Cassidy
J David
JD
Ahlbom
Anders
A
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006261:Headache / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D008297:Male; D019547:Neck Pain / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D016017:Odds Ratio; D010147:Pain Measurement; D012959:Socioeconomic Factors; D014911:Whiplash Injuries / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology