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Course and Prognostic Factors for Neck Pain in Whiplash-Associated Disorders (WAD)

Results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders

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European Spine Journal Aims and scope Submit manuscript

Study Design

Best evidence synthesis.

Objective

To perform a best evidence synthesis on the course and prognostic factors for neck pain and its associated disorders in Grades I–III whiplash-associated disorders (WAD).

Summary of Background Data

Knowledge of the course of recovery of WAD guides expectations for recovery. Identifying prognostic factors assists in planning management and intervention strategies and effective compensation policies to decrease the burden of WAD.

Methods

The Bone and Joint Decade 2000–2010 Task Force on Neck Pain and its Associated Disorders (Neck Pain Task Force) conducted a critical review of the literature published between 1980 and 2006 to assemble the best evidence on neck pain and its associated disorders. Studies meeting criteria for scientific validity were included in a best evidence synthesis.

Results

We found 226 articles related to course and prognostic factors in neck pain and its associated disorders. After a critical review, 70 (31%) were accepted on scientific merit; 47 of these studies related to course and prognostic factors in WAD. The evidence suggests that approximately 50% of those with WAD will report neck pain symptoms 1 year after their injuries. Greater initial pain, more symptoms, and greater initial disability predicted slower recovery. Few factors related to the collision itself (for example, direction of the collision, headrest type) were prognostic; however, postinjury psychological factors such as passive coping style, depressed mood, and fear of movement were prognostic for slower or less complete recovery. There is also preliminary evidence that the prevailing compensation system is prognostic for recovery in WAD.

Conclusion

The Neck Pain Task Force undertook a best evidence synthesis to establish a baseline of the current best evidence on the course and prognosis for WAD. Recovery of WAD seems to be multifactorial.

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Author information

Authors and Affiliations

  1. Department of Public Health Sciences, University of Alberta, Edmonton, Canada

    Linda J. Carroll PhD

  2. The Alberta Centre for Injury Control and Research, School of Public Health, University of Alberta, Edmonton, Canada

    Linda J. Carroll PhD

  3. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

    Lena W. Holm DrMedSc

  4. Institute for Work and Health, Toronto, Canada

    Sheilah Hogg-Johnson PhD, Pierre Côté DC, PhD & Gabrielle van der Velde DC

  5. Department of Public Health Sciences, University of Toronto, Toronto, Canada

    Sheilah Hogg-Johnson PhD

  6. Departments of Public Health Sciences, and Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada

    Pierre Côté DC, PhD & J. David Cassidy DC, PhD, DrMedSc

  7. Centre of Research Expertise in Improved Disability Outcomes (CREIDO), University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, Canada

    Pierre Côté DC, PhD, J. David Cassidy DC, PhD, DrMedSc & Gabrielle van der Velde DC

  8. Division of Health Care and Outcomes Research, Toronto Western Research Institute, Toronto, Canada

    Pierre Côté DC, PhD, J. David Cassidy DC, PhD, DrMedSc & Gabrielle van der Velde DC

  9. Department of Neurology, University of California, Irvine, CA, USA

    Scott Haldeman DC, MD, PhD

  10. Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA

    Scott Haldeman DC, MD, PhD

  11. Departments of Orthopaedics and Environmental Medicine and Program of Ergonomics and Biomechanics, School of Medicine and Graduate School of Arts and Science, New York University, New York, NY, USA

    Margareta Nordin PT, DrMedSc

  12. Occupational and Industrial Orthopaedic Center (OIOC), New York University Medical Center, New York, NY, USA

    Margareta Nordin PT, DrMedSc

  13. Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii at Mānoa, Honolulu, HI, USA

    Eric L. Hurwitz DC, PhD

  14. Department of Orthopaedic Surgery, Stanford University School of Medicine, Standford, CA, USA

    Eugene J. Carragee MD, FACS

  15. Orthopaedic Spine Center and Spinal Surgery Service, Stanford University Hospital and Clinics, Standford, CA, USA

    Eugene J. Carragee MD, FACS

  16. Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada

    Gabrielle van der Velde DC

  17. Endocrinology, Analgesia and Inflammation, Merck & Co., Rahway, NJ, USA

    Paul M. Peloso MD, MSc, FRCP(C)

  18. Department of Medicine, University of British Columbia, Vancouver, Canada

    Jaime Guzman MD, MSc, FRCP(C)

  19. Occupational Health and Safety Agency for Healthcare in British Columbia, Vancouver, Canada

    Jaime Guzman MD, MSc, FRCP(C)

  20. 4075 RTF, University of Alberta, Edmonton, Alberta, Canada, T6G 2E1

    Linda J. Carroll PhD

Authors
  1. Linda J. Carroll PhD
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  2. Lena W. Holm DrMedSc
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  3. Sheilah Hogg-Johnson PhD
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  4. Pierre Côté DC, PhD
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  5. J. David Cassidy DC, PhD, DrMedSc
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  6. Scott Haldeman DC, MD, PhD
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  7. Margareta Nordin PT, DrMedSc
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  8. Eric L. Hurwitz DC, PhD
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  9. Eugene J. Carragee MD, FACS
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  10. Gabrielle van der Velde DC
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  11. Paul M. Peloso MD, MSc, FRCP(C)
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  12. Jaime Guzman MD, MSc, FRCP(C)
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Corresponding author

Correspondence to Linda J. Carroll PhD.

Additional information

The manuscript submitted does not contain information about medical device(s)/drug(s).

Corporate/Industry, Foundation, and Professional Organizational funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

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Carroll, L.J., Holm, L.W., Hogg-Johnson, S. et al. Course and Prognostic Factors for Neck Pain in Whiplash-Associated Disorders (WAD). Eur Spine J 17 (Suppl 1), 83–92 (2008). https://doi.org/10.1007/s00586-008-0628-7

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