European Spine Journal

, Volume 17, Supplement 1, pp 52–59

The Burden and Determinants of Neck Pain in Whiplash-Associated Disorders After Traffic Collisions

Results of the Bone and Joint Decade 2000 –2010 Task Force on Neck Pain and Its Associated Disorders
  • Lena W. Holm
  • Linda J. Carroll
  • J. David Cassidy
  • Sheilah Hogg-Johnson
  • Pierre Côté
  • Jamie Guzman
  • Paul Peloso
  • Margareta Nordin
  • Eric Hurwitz
  • Gabrielle van der Velde
  • Eugene Carragee
  • Scott Haldeman
Best Evidence

DOI: 10.1007/s00586-008-0625-x

Cite this article as:
Holm, L.W., Carroll, L.J., Cassidy, J.D. et al. Eur Spine J (2008) 17(Suppl 1): 52. doi:10.1007/s00586-008-0625-x
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Study Design

Best evidence synthesis.

Objective

To undertake a best evidence synthesis on the burden and determinants of whiplash-associated disorders (WAD) after traffic collisions.

Study Design

Summary of Background Data. Previous best evidence synthesis on WAD has noted a lack of evidence regarding incidence of and risk factors for WAD. Therefore there was a warrant of a reanalyze of this body of research.

Methods

A systematic search of Medline was conducted. The reviewers looked for studies on neck pain and its associated disorders published 1980 –2006. Each relevant study was independently and critically reviewed by rotating pairs of reviewers. Data from studies judged to have acceptable internal validity (scientifically admissible) were abstracted into evidence tables, and provide the body of the best evidence synthesis.

Results

The authors found 32 scientifically admissible studies related to the burden and determinants of WAD. In the Western world, visits to emergency rooms due to WAD have increased over the past 30 years. The annual cumulative incidence of WAD differed substantially between countries. They found that occupant seat position and collision impact direction were associated with WAD in one study. Eliminating insurance payments for pain and suffering were associated with a lower incidence of WAD injury claims in one study. Younger ages and being a female were both associated with filing claims or seeking care for WAD, although the evidence is not consistent. Preliminary evidence suggested that headrests/car seats, aimed to limiting head extension during rear-end collisions had a preventive effect on reporting WAD, especially in females.

Conclusion

WAD after traffic collisions affects many people. Despite many years of research, the evidence regarding risk factors for WAD is sparse but seems to include personal, societal, and environmental factors. More research including, well-defined studies with accurate denominators for calculating risk, and better consideration of confounding factors, are needed.

Keywords

neck injurywhiplash-associated disorderstraffic collisionsystematic reviewepidemiology

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Lena W. Holm
    • 1
    • 2
    • 4
  • Linda J. Carroll
    • 2
  • J. David Cassidy
    • 3
    • 4
    • 5
  • Sheilah Hogg-Johnson
    • 6
  • Pierre Côté
    • 7
    • 8
    • 9
    • 10
  • Jamie Guzman
    • 11
  • Paul Peloso
    • 12
  • Margareta Nordin
    • 13
    • 14
  • Eric Hurwitz
    • 15
  • Gabrielle van der Velde
    • 16
    • 17
    • 4
    • 18
  • Eugene Carragee
    • 19
    • 20
  • Scott Haldeman
    • 21
    • 22
  1. 1.Institute of Environmental MedicineKarolinska InstitutetStockholmSweden
  2. 2.Department of Public Health Sciences, and the Alberta Centre for Injury Control and Research, School of Public HealthUniversity of AlbertaAlbertaCanada
  3. 3.Centre of Research Expertise in Improved Disability Outcomes (CREIDO)University Health Network Rehailitation SolutionsTorontoCanada
  4. 4.Division of Health Care and Outcomes ResearchToronto Western Research InstituteTorontoCanada
  5. 5.Departments of Public Health Sciences and Health Policy, Managemen tand EvaluationUniversity of TorontoTorontoCanada
  6. 6.Institute for Work and Health, Department of Public Health SciencesUniversity of TorontoTorontoCanada
  7. 7.Departments of Public Health Sciences and Health Policy, Management and EvaluationUniversity of TorontoTorontoCanada
  8. 8.Division of Health Care and Outcomes ResearchToronto Western Research InstituteTorontoCanada
  9. 9.Centre of Research Expertise in Improved Disability Outcomes (CREIDO)University Health Network Rehabilitation Solutions, Toronto Western HospitalTorontoCanada
  10. 10.Institute for Work & HealthTorontoCanada
  11. 11.Department of MedicineUniversity of British Columbia; Occupational Health and Safety Agency for Health care in BCColumbiaCanada
  12. 12.Endocrinology, Analgesia and InflammationMerck & CoRahwayUSA
  13. 13.Departments of Orthopaedics and Environmental Medicine and Program of Ergonomics and Biomechanics, School of Medicine and Graduate School of Arts and ScienceNewYork UniversityNewYorkUSA
  14. 14.Occupational and Industrial Orthopaedic Center(OIOC)NewYork University Medical CenterNewYorkUSA
  15. 15.Department of Public Health Sciences, John A. Burns School of MedicineUniversity of Hawaii at ManoaHonoluluHawaii
  16. 16.Institute for Work and HealthTorontoCanada
  17. 17.Department of Health Policy, Management and EvaluationUniversity of TorontoTorontoCanada
  18. 18.Centre of Research Excellence in Improved Disability Outcomes(CREIDO)University Health Network Rehabilitation Solutions, Toronto Western HospitalTorontoCanada
  19. 19.Department of Orthopaedic SurgeryStanford University School of MedicineStanfordUSA
  20. 20.Orthopaedic Spine Center and Spinal Surgery ServiceStanford University Hospital and ClinicsStanfordUSA
  21. 21.Department of NeurologyUniversity of CaliforniaIrvineUSA
  22. 22.Department of Epidemiology, School of Public HealthUniversity of CaliforniaLos AngelesUSA
  23. 23.Institute of Environmental Medicine, Division of EpidemiologyKarolinska InstitutetStockholmSweden