title: Sex-based differences in pain distribution in a cohort of patients with persistent post-traumatic neck pain.
abstract: To analyze a cohort of 745 consecutive patients referred to a regional specialist clinic for evaluation of post-traumatic neck pain during a five-year period.
  
  
  
  A cross-sectional observational study of baseline assessments performed by multi-professional rehabilitation teams according to a standardized checklist.
  
  
  
  The cohort contained nearly twice as many females as males (64% versus 36%). The type of injury did not differ between sexes. Of the entire cohort, 38% were diagnosed with widespread pain, 50% with regional pain, and 12% with local pain. The pain distribution among the females was 43% widespread, 48% regional, and 9% local, and corresponding figures among males were 29%, 53%, and 18%. Longer time between trauma and assessment did not affect pain distribution among the men, but a tendency towards more widespread pain was observed among the women.
  
  
  
  The importance of "female sex" as risk factor for the development of persistent pain after neck trauma needs to be discussed further. The high frequency of regional and widespread pain among patients with persistent neck pain after trauma calls for both multidisciplinary assessments and treatment strategies. The relationships between different pain distribution patterns, disability, activity, and psychological factors need to be studied further. Implications for rehabilitation Patients suffering from pain and disability after neck trauma constitute a significant proportion of patients with persistent pain. The importance of the risk factor "female sex" should be further discussed in the development of persistent pain after neck trauma. The high frequency of regional and widespread pain among patients with persistent neck pain after trauma calls both for multidisciplinary assessments and treatment strategies. The relationships between different pain distribution patterns, disability, activity, and psychological factors need to be studied further.
authors.affiliation: a Department of Pain Rehabilitation , Skåne University Hospital , Lund , Sweden.|b Department of Health Sciences , Lund University , Lund , Sweden.
authors.forename: Hans
authors.identifier: 0000-0002-4052-9692
authors.initials: H
authors.lastname: Westergren
authors.affiliation: a Department of Pain Rehabilitation , Skåne University Hospital , Lund , Sweden.
authors.forename: Johan
authors.identifier: 0000-0002-4029-5945
authors.initials: J
authors.lastname: Larsson
authors.affiliation: c Department of Psychiatry , Oregon Health & Science University School of Medicine , Portland , OR , USA.|d School for Public Health and Primary Care CAPHRI , Maastricht University Medical Center , Maastricht , The Netherlands.
authors.forename: Michael
authors.identifier: 0000-0003-0228-3158
authors.initials: M
authors.lastname: Freeman
authors.affiliation: e Chalmers Industrial Technology (CIT) , Gothenburg , Sweden.
authors.forename: Anna
authors.identifier: 0000-0002-3216-8145
authors.initials: A
authors.lastname: Carlsson
authors.affiliation: f Division of Occupational and Environmental Medicine , Department of Laboratory Medicine Lund, Lund University , Lund , Sweden.
authors.forename: Anna
authors.identifier: 0000-0001-7192-4911
authors.initials: A
authors.lastname: Jöud
authors.affiliation: a Department of Pain Rehabilitation , Skåne University Hospital , Lund , Sweden.|g Department of Otorhinolaryngology, Clinical Sciences, Lund University , Lund , Sweden.
authors.forename: Eva-Maj
authors.identifier: 0000-0003-0380-826X
authors.initials: EM
authors.lastname: Malmström
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation; D010146:Pain / Q000534:rehabilitation; D010147:Pain Measurement / Q000379:methods; D012307:Risk Factors; D012737:Sex Factors; D013995:Time; D014911:Whiplash Injuries / Q000150:complications / Q000534:rehabilitation
keywords: Whiplash trauma; gender differences; pain distribution; persistent pain; sex characteristics