Prognostic factors for chronic neck pain in persons with Minor or moderate injuries in traffic accidents

Prognostic factors for chronic neck pain in persons with Minor or moderate injuries in traffic accidents
Received 28 February 2006; revised 5 June 2006; accepted 22 June 2006. Available online 24 August 2006.
Eivind Papea, , Jens Ivar Broxb, c, , K¬re Birger Hagend, , , B¬rd Natvige, and Helge Schirmerf,
Accident Analysis & Prevention
ScienceDirect

Copyright © 2006 Elsevier Ltd All rights reserved.

aExpert Services Medicine, If P&C Insurance Company Ltd., P.O. Box 240, 1326 Lysaker, Norway
bSection for Back Surgery and Physical Medicine and Rehabilitation, Orthopaedic Department, Rikshospitalet University Hospital, Oslo, Norway
cUnifob Health, University of Bergen, Norway
dNational Resource Centre for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, P.O. Box 23 Vindern, 0319 Oslo, Norway
eUniversity of Oslo, Department of General Practice and Community Medicine, P.O. Box 1130 Blindern. 0317 Oslo, Norway
fOmnia Hospital, Fr. Stangsgt. 11/13, N-0264 Oslo, Norway

Abstract
Prognostic factors for chronic neck pain were identified in a prospective Norwegian insurance cohort comprising 636 persons with minor or moderate traffic injuries.

One questionnaire was used at baseline and another at 3 years post-injury. Daily severe or very severe neck pain at three years follow up was defined as chronic neck pain.

Eight significant independent prognostic factors for chronic neck pain were identified: (1) rear-end or frontal and rear-end collision, odds ratio (OR): 4.10 (95% confidence interval (CI): 1.72Ò10.82); (2) neck and/or shoulder pain before the accident, OR: 2.38 (95% CI: 1.07Ò5.37); (3) post-accident (a) memory and concentration problems, OR: 4.62 (95% CI: 1.99Ò11.20), (b) bodily tension, OR: 3.43 (95% CI: 1.49Ò8.42), (c) difficulties to climb stairs, OR: 5.03 (95% CI: 1.77Ò14.95), (d) difficulties to bend forward, OR: 4.85 (95% CI: 2.06Ò11.79), (e) difficulties to do heavy labour, OR: 3.70 (95% CI: 1.24Ò11.64); (4) beliefs in future work disability, OR: 2.64 (95% CI: 1.11Ò6.48).

The results indicate that development of chronic neck pain is influenced by pre-accident neck and/or shoulder pain, the impact of the collision, as well as post-accident symptoms, perceived impaired function and pessimism for the future ability to work.

Keywords: Whiplash injury; Traffic accident; Neck injury; Chronic neck pain; Prognosis

Corresponding author. Tel.: +47 22454855; fax: +47 22454850.

You can view the abstract online. A subscription is required to view the full text or it can be purchased online.