Factors influencing neck pain intensity in whiplash-associated disorders in Sweden.
OBJECTIVE
To investigate if sociodemographic and economic factors, preinjury health status, and collision factors are associated with initial neck pain intensity in whiplash-associated disorders (WAD) in Sweden. The factors of interest were demographic and socioeconomic factors, prior health, and collision factors.


METHODS
A cohort study of car occupants, insured by either of 2 Swedish traffic insurers, age 18 to 74 years, who filed an injury claim and reported WAD after a motor vehicle collision (n=1187) were approached with mailed questionnaires. These contained questions about prior health, details about the collision, and symptoms after the collision. Neck pain intensity was measured on a visual analog scale and categorized into mild pain (0 to 30 mm), moderate pain (31 to 54 mm), and severe pain (55 to 100 mm).


RESULTS
Low educational level [odds ratio (OR) 2.8; 95% confidence interval (CI) 1.8-4.5], being sole adult in the family (OR 1.6; 95%CI 1.1-2.2), prior neck pain (OR 2.9; 95%CI 1.4-6.2), prior headache (OR 2.2; 95%CI 0.7-6.9), prior poor general health (OR 2.6; 95%CI 1.4-4.8), and exposure to rollover collision (OR 1.9; 95%CI 1.0-3.8) were all associated with severe initial neck pain intensity. Most of these factors were also associated with moderate pain intensity.


CONCLUSIONS
This study confirms results from a previous study that sociodemographic and economic status, preinjury health status, and collision-related factors are associated with participants' rating of initial neck pain intensity in WAD. The findings are of importance for interpreting and understanding the underlying factors of pain rating.
Holm
Lena W
LW
Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. Lena.Holm@ki.se
Carroll
Linda J
LJ
David Cassidy
J
J
Ahlbom
Anders
A
D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology*; D010147:Pain Measurement; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D013548:Sweden; D014911:Whiplash Injuries / Q000175:diagnosis* / Q000453:epidemiology*