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European Spine Journal

, Volume 17, Supplement 1, pp 83–92 | Cite as

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
  • Linda J. Carroll
  • Lena W. Holm
  • Sheilah Hogg-Johnson
  • Pierre Côté
  • J. David Cassidy
  • Scott Haldeman
  • Margareta Nordin
  • Eric L. Hurwitz
  • Eugene J. Carragee
  • Gabrielle van der Velde
  • Paul M. Peloso
  • Jaime Guzman
Best Evidence

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.

Key words

neck pain systematic review epidemiology prognosis whiplash 

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Linda J. Carroll
    • 1
    • 2
    • 20
  • Lena W. Holm
    • 3
  • Sheilah Hogg-Johnson
    • 4
    • 5
  • Pierre Côté
    • 6
    • 7
    • 8
    • 4
  • J. David Cassidy
    • 6
    • 7
    • 8
  • Scott Haldeman
    • 9
    • 10
  • Margareta Nordin
    • 11
    • 12
  • Eric L. Hurwitz
    • 13
  • Eugene J. Carragee
    • 14
    • 15
  • Gabrielle van der Velde
    • 4
    • 7
    • 8
    • 16
  • Paul M. Peloso
    • 17
  • Jaime Guzman
    • 18
    • 19
  1. 1.Department of Public Health SciencesUniversity of AlbertaEdmontonCanada
  2. 2.The Alberta Centre for Injury Control and Research, School of Public HealthUniversity of AlbertaEdmontonCanada
  3. 3.Institute of Environmental MedicineKarolinska InstitutetStockholmSweden
  4. 4.Institute for Work and HealthTorontoCanada
  5. 5.Department of Public Health SciencesUniversity of TorontoTorontoCanada
  6. 6.Departments of Public Health Sciences, and Health Policy, Management and EvaluationUniversity of TorontoTorontoCanada
  7. 7.Centre of Research Expertise in Improved Disability Outcomes (CREIDO)University Health Network Rehabilitation Solutions, Toronto Western HospitalTorontoCanada
  8. 8.Division of Health Care and Outcomes ResearchToronto Western Research InstituteTorontoCanada
  9. 9.Department of NeurologyUniversity of CaliforniaIrvineUSA
  10. 10.Department of Epidemiology, School of Public HealthUniversity of CaliforniaLos AngelesUSA
  11. 11.Departments of Orthopaedics and Environmental Medicine and Program of Ergonomics and Biomechanics, School of Medicine and Graduate School of Arts and ScienceNew York UniversityNew YorkUSA
  12. 12.Occupational and Industrial Orthopaedic Center (OIOC)New York University Medical CenterNew YorkUSA
  13. 13.Department of Public Health SciencesJohn A. Burns School of Medicine, University of Hawaii at MānoaHonoluluUSA
  14. 14.Department of Orthopaedic SurgeryStanford University School of MedicineStandfordUSA
  15. 15.Orthopaedic Spine Center and Spinal Surgery ServiceStanford University Hospital and ClinicsStandfordUSA
  16. 16.Department of Health Policy, Management and EvaluationUniversity of TorontoTorontoCanada
  17. 17.Endocrinology, Analgesia and InflammationMerck & Co.RahwayUSA
  18. 18.Department of MedicineUniversity of British ColumbiaVancouverCanada
  19. 19.Occupational Health and Safety Agency for Healthcare in British ColumbiaVancouverCanada
  20. 20.4075 RTFUniversity of Alberta, EdmontonAlbertaCanada

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