title: Effect of pain location and duration on life function in the year after motor vehicle collision.
abstract: Persistent musculoskeletal pain is common after motor vehicle collision (MVC) and often results in substantial disability. The objective of this study was to identify distributions of post-MVC pain that most interfere with specific life functions and that have the greatest interference with aggregate life function. Study data were obtained from a prospective longitudinal multicenter emergency department-based cohort of 948 European Americans experiencing MVC. Overall pain (0-10 numeric rating scale [NRS]), pain in each of 20 body regions (0-10 NRS), and pain interference (Brief Pain Inventory, 0-10 NRS) were assessed 6 weeks, 6 months, and 1 year after MVC. After adjustment for overall pain intensity, an axial distribution of pain caused the greatest interference with most specific life functions (R(2)=0.15-0.28, association P values of <.001) and with overall function. Axial pain explained more than twice as much variance in pain interference as other pain distributions. However, not all patients with axial pain had neck pain. Moderate or severe low back pain was as common as neck pain at week 6 (prevalence 37% for each) and overlapped with neck pain in only 23% of patients. Further, pain across all body regions accounted for nearly twice as much of the variance in pain interference as neck pain alone (60% vs 34%). These findings suggest that studies of post-MVC pain should not focus on neck pain alone.
authors: Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC, USA Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA Department of Emergency Medicine, Spectrum Health Hospital-Butterworth Campus, Grand Rapids, MI, USA Department of Emergency Medicine, William Beaumont Hospital, Royal Oak, MI, USA Department of Emergency Medicine, St Joseph Mercy Hospital, Ann Arbor, MI, USA Department of Emergency Medicine, North Shore University Hospital, Manhasset, NY, USA Department of Emergency Medicine, Baystate Medical Center, Springfield, MA, USA Department of Emergency Medicine, College of Medicine, University of Florida and Shands Jacksonville, Jacksonville, FL, USA Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL, USA.
authors: Andrey V
authors: AV
authors: Bortsov
authors: Timothy F
authors: TF
authors: Platts-Mills
authors: David A
authors: DA
authors: Peak
authors: Jeffrey S
authors: JS
authors: Jones
authors: Robert A
authors: RA
authors: Swor
authors: Robert M
authors: RM
authors: Domeier
authors: David C
authors: DC
authors: Lee
authors: Niels K
authors: NK
authors: Rathlev
authors: Phyllis L
authors: PL
authors: Hendry
authors: Roger B
authors: RB
authors: Fillingim
authors: Samuel A
authors: SA
authors: McLean
mesh_terms: D000063:Accidents, Traffic; D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000503:physiopathology*; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D055815:Young Adult
keywords: Motor vehicle collision; Musculoskeletal pain; Pain interference; Whiplash