Traumatic injury and traumatic stress.
METHODS
To review findings from recent research in consideration of relevant theoretical models between post-traumatic stress disorder (PTSD) and pain, and to review emerging interventions and prevention options for PTSD in individuals with whiplash.


OBJECTIVE
A traumatic accident may lead to whiplash injury, but can also frequently lead to post-traumatic stress. There is concern that this occurrence is more problematic than each disorder separately. Furthermore, it is unclear why this might occur. This review addresses two mechanisms that might explain this, specifically arousal and pain.


BACKGROUND
There is a growing body of research revealing relationships between injury, pain and psychological trauma with important implications for the prevention and management of chronic pain and post-traumatic reactions. Intervention for PTSD in the context of whiplash has been shown to be effective, and seems to have a beneficial effect on the whiplash injury. The intervention for traumatic stress in acute whiplash presents further challenges.


METHODS
This chapter will review findings from recent research in consideration of relevant theoretical models between PTSD and pain in general and more specifically in the case of pain resulting from whiplash injury. A review of emerging interventions and prevention options for PTSD in individuals with whiplash will also be discussed to provide a basis for treatment of individuals and future research.


RESULTS
Recent work in this area suggests that stress, pain and arousal interact through the effects of tissue injury and the distress in response to perceived threat. Post-traumatic stress plays an important role in a significant proportion of whiplash sufferers as its presence seems to deleteriously impact recovery.


CONCLUSIONS
Intervention for PTSD in the context of whiplash has been shown to be effective, and seems to have a beneficial effect on the whiplash injury. The intervention for traumatic stress in acute whiplash presents further challenges.
Centre of National Research on Disability and Rehabilitation, School of Medicine, University of Queensland, Australia. j.kenardy@uq.edu.au
Justin
J
Kenardy
Rachael
R
Dunne
D006801:Humans; D010146:Pain / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D013315:Stress, Psychological / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D014911:Whiplash Injuries / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D014947:Wounds and Injuries / Q000150:complications / Q000503:physiopathology* / Q000523:psychology