A neuropathic pain component is common in acute whiplash and associated with a more complex clinical presentation.
Whiplash is a heterogeneous condition with some individuals showing features suggestive of neuropathic pain. This study investigated the presence of a neuropathic pain component in acute whiplash using the Self-reported Leeds Assessment of Neuropathic Signs and Symptoms' scale (S-LANSS) and evaluated relationships among S-LANSS responses, pain/disability, sensory characteristics (mechanical, thermal pain thresholds, and Brachial plexus provocation test (BPPT) responses) and psychological distress (General Health Questionnaire-28 (GHQ-28)). Participants were 85 people with acute whiplash (<4 weeks) (54 females, age 36.27+/-12.69 years). Thirty-four percent demonstrated a predominantly neuropathic pain component (S-LANSS>or=12). This group showed higher pain/disability, cold hyperalgesia, cervical mechanical hyperalgesia, and less elbow extension with the BPPT (p<0.03) when compared to the group with non-neuropathic pain (S-LANSS<or=12). Pressure pain thresholds (PPTs) at distant sites and psychological distress (GHQ-28) were not different between the groups (p>0.09). None of the S-LANSS items could discriminate those with cold hyperalgesia (p=0.06). A predominantly neuropathic pain component is related to a complex presentation of higher pain/disability and sensory hypersensitivity. The S-LANSS may be a useful tool and the BPPT a useful clinical test in the early assessment of whiplash.
Sterling
Michele
M
Centre of National Research on Disability and Rehabilitation Medicine, The University of Queensland, Mayne Medical School, Herston, QLD, Australia. m.sterling@uq.edu.au
Pedler
Ashley
A
D000063:Accidents, Traffic; D000208:Acute Disease; D000328:Adult; D017677:Age Distribution; D020516:Brachial Plexus Neuropathies / Q000175:diagnosis* / Q000453:epidemiology / Q000534:rehabilitation; D015331:Cohort Studies; D004185:Disability Evaluation; D004576:Electromyography; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010147:Pain Measurement; D017288:Pain Threshold; D011336:Probability; D011379:Prognosis; D011581:Psychological Tests; D011584:Psychology; D011788:Quality of Life; D012307:Risk Factors; D012678:Sensation Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000534:rehabilitation; D012684:Sensory Thresholds; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014911:Whiplash Injuries / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D055815:Young Adult