title: The association between a lifetime history of a neck injury in a motor vehicle collision and future neck pain: a population-based cohort study.
abstract: The objective of this population-based cohort study was to investigate the association between a lifetime history of neck injury from a motor vehicle collision and the development of troublesome neck pain. The current evidence suggests that individuals with a history of neck injury in a traffic collision are more likely to experience future neck pain. However, these results may suffer from residual confounding. Therefore, there is a need to test this association in a large population-based cohort with adequate control of known confounders. We formed a cohort of 919 randomly sampled Saskatchewan adults with no or mild neck pain in September 1995. At baseline, participants were asked if they ever injured their neck in a motor vehicle collision. Six and twelve months later, we asked about the presence of troublesome neck pain (grade II-IV) on the chronic pain grade questionnaire. Multivariable Cox regression was used to estimate the association between a lifetime history of neck injury in a motor vehicle collision and the onset of troublesome neck pain while controlling for known confounders. The follow-up rate was 73.5% (676/919) at 6 months and 63.1% (580/919) at 1 year. We found a positive association between a history of neck injury in a motor vehicle collision and the onset of troublesome neck pain after controlling for bodily pain and body mass index (adjusted HRR = 2.14; 95% CI 1.12-4.10). Our analysis suggests that a history of neck injury in a motor vehicle collision is a risk factor for developing future troublesome neck pain. The consequences of a neck injury in a motor vehicle collision can have long lasting effects and predispose individuals to experience recurrent episodes of neck pain.
authors.affiliation: Centre of Research Expertise in Improved Disability Outcomes, University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, Canada. pnolet@rogers.com
authors.forename: Paul S
authors.initials: PS
authors.lastname: Nolet
authors.forename: Pierre
authors.initials: P
authors.lastname: Côté
authors.forename: J David
authors.initials: JD
authors.lastname: Cassidy
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Carroll
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality* / Q000706:statistics & numerical data; D000328:Adult; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000453:epidemiology* / Q000503:physiopathology; D019547:Neck Pain / Q000453:epidemiology* / Q000503:physiopathology; D010147:Pain Measurement / Q000379:methods; D015995:Prevalence; D012525:Saskatchewan / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013995:Time