A psycho-educational video used in the emergency department provides effective treatment for whiplash injuries.
METHODS
Randomized control trial conducted between June 2000 and September 2002.


OBJECTIVE
To determine whether a short psycho-educational video shown in the Emergency Department shortly after the injury would produce follow-up pain reductions and reduced medical utilization.


BACKGROUND
Chronic pain following a whiplash injury is one example of the massive medical/legal problem of chronic muscular pain. Approaches using local pain sources (trigger points) have shown promise as treatment models for this type of pain.


METHODS
1) SETTING: Emergency Departments (ED) and urgent care (UC) facilities. 2) PATIENTS: 126 patients entering EDs or UCs. 3) INTERVENTION: PATIENTS assigned to 12-minute video or care as usual. 4) MAIN OUTCOME MEASURES: Short Form Musculoskelatal Function Assessment (SMFA), phone questionnaires assessing: narcotics use, ER use, UC use, surgical consultations, etc.


CONCLUSIONS
PATIENTS viewing the video had dramatically lower pain ratings at a 1-month follow (6.09 [10.6] vs. 21.23 [17.4], P < 0.001) and this pattern held for the 3- and 6-month follow-up period. Similarly, for 17 of 21 items asked at follow-up, the video group showed superior outcomes (chi2 ranged from 5 to 35, P < 0.05, all). For example, 4% of video patients were using narcotics at 6 month post ED visit compared with 36% of controls. The brief psycho-educational video had a profound effect on subsequent pain and medical utilization.
Oliveira
Ali
A
California School of Professional Psychology at Alliant International University, San Diego, CA, USA.
Gevirtz
Richard
R
Hubbard
David
D
D000328:Adult; D002908:Chronic Disease; D004632:Emergency Medical Services / Q000379:methods*; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009209:Myofascial Pain Syndromes / Q000209:etiology / Q000523:psychology / Q000628:therapy; D010146:Pain / Q000209:etiology / Q000523:psychology; D059408:Pain Management; D010147:Pain Measurement; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction; D011603:Psychophysiology; D016896:Treatment Outcome; D014743:Videotape Recording; D014911:Whiplash Injuries / Q000150:complications / Q000523:psychology* / Q000628:therapy*