Course and prognostic factors for neck pain in whiplash-associated disorders (WAD): results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders.
METHODS
Best evidence synthesis.


OBJECTIVE
To perform a best evidence synthesis on the course and prognostic factors for neck pain and its associated disorders in Grades I-III whiplash-associated disorders (WAD).


BACKGROUND
Knowledge of the course of recovery of WAD guides expectations for recovery. Identifying prognostic factors assists in planning management and intervention strategies and effective compensation policies to decrease the burden of WAD.


METHODS
The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders (Neck Pain Task Force) conducted a critical review of the literature published between 1980 and 2006 to assemble the best evidence on neck pain and its associated disorders. Studies meeting criteria for scientific validity were included in a best evidence synthesis.


RESULTS
We found 226 articles related to course and prognostic factors in neck pain and its associated disorders. After a critical review, 70 (31%) were accepted on scientific merit; 47 of these studies related to course and prognostic factors in WAD. The evidence suggests that approximately 50% of those with WAD will report neck pain symptoms 1 year after their injuries. Greater initial pain, more symptoms, and greater initial disability predicted slower recovery. Few factors related to the collision itself (for example, direction of the collision, headrest type) were prognostic; however, postinjury psychological factors such as passive coping style, depressed mood, and fear of movement were prognostic for slower or less complete recovery. There is also preliminary evidence that the prevailing compensation system is prognostic for recovery in WAD.


CONCLUSIONS
The Neck Pain Task Force undertook a best evidence synthesis to establish a baseline of the current best evidence on the course and prognosis for WAD. Recovery of WAD seems to be multifactorial.
Carroll
Linda J
LJ
Department of Public Health Sciences, School of Public Health, University of Alberta, Canada. lcarroll@ualberta.ca
Holm
Lena W
LW
Hogg-Johnson
Sheilah
S
Côté
Pierre
P
Cassidy
J David
JD
Haldeman
Scott
S
Nordin
Margareta
M
Hurwitz
Eric L
EL
Carragee
Eugene J
EJ
van der Velde
Gabrielle
G
Peloso
Paul M
PM
Guzman
Jaime
J
D000223:Adaptation, Psychological; D026683:Advisory Committees; D015897:Comorbidity; D035881:Compensation and Redress; D003710:Demography; D018450:Disease Progression; D006801:Humans; D019547:Neck Pain / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D011379:Prognosis; D012959:Socioeconomic Factors; D014911:Whiplash Injuries / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology