title: Physical and Psychosocial Factors Associated with Neck Pain after Major Accidental Trauma.
abstract: Neck pain after physical trauma is common; but previous research regarding the role of psychological and physical predictors for neck pain is inconsistent. A retrospective survey of consecutive patients presenting to a metropolitan trauma centre with major accidental trauma was performed between 1 and 6 years post injury. Possible predictor variables (demographic, injury severity, and psychosocial factors) were determined from the hospital trauma registry and the questionnaire. The main outcome was a combined score of neck pain severity and functional limitation. Multivariate logistic regression was performed to develop a predictive model for neck pain. A multivariate analysis of 355 patients showed that neck pain was not significantly associated with measures of injury severity. Neck pain was significantly more likely to be severe in patients with a cervical spine fracture, with pre-existing chronic illnesses, those with post-traumatic stress disorder (PTSD) at the time of follow up, those who had retained the services of a lawyer regarding the injury, and those with lower education levels. Psychosocial factors are important predictors of neck pain after major physical trauma. These findings do not support models for post-traumatic neck pain that are restricted to physical factors.
authors.affiliation: Orthopaedic Department, Liverpool Hospital, Liverpool, NSW, Australia. ian.harris@sswahs.nsw.gov.au.|Orthopaedic Department, Liverpool Hospital, Liverpool, NSW, 2170, Australia. ian.harris@sswahs.nsw.gov.au.
authors.forename: Ian A
authors.initials: IA
authors.lastname: Harris
authors.affiliation: Surgical Outcome Research Centre, Camperdown, NSW, Australia.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Young
authors.affiliation: Orthopaedic Department, Liverpool Hospital, Liverpool, NSW, Australia.
authors.forename: Hamish
authors.initials: H
authors.lastname: Rae
authors.affiliation: Centre for Research, Evidence Management and Surveillance, Liverpool Hospital, Liverpool, NSW, Australia.
authors.forename: Bin B
authors.initials: BB
authors.lastname: Jalaludin
authors.affiliation: Surgical Outcome Research Centre, Camperdown, NSW, Australia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Solomon
keywords: Epidemiology; Injury; Neck pain; Trauma; Whiplash