European Spine Journal

, Volume 21, Issue 8, pp 1528–1535 | Cite as

Pre-injury health-related factors in relation to self-reported whiplash: longitudinal data from the HUNT study, Norway

  • Hanne Gro Wenzel
  • Ottar Vasseljen
  • Arnstein Mykletun
  • Tom Ivar Lund Nilsen
Original Article

Abstract

Purpose

To examine if pre-injury health-related factors are associated with the subsequent report of whiplash, and more specifically, both whiplash and neck pain.

Methods

Longitudinal population study of 40,751 persons participating in two consecutive health surveys with 11 years interval. We used logistic regression to estimate odds ratio (OR) for reporting whiplash or whiplash with neck pain lasting at least 3 months last year, related to pre-injury health as indicated by subjective health, mental and physical impairment, use of health services, and use of medication. All associations were adjusted for socio-demographic factors.

Results

The OR for reporting whiplash was increased in people reporting poor health at baseline. The ORs varied from 1.47 (95% CI 1.13–1.91) in people visiting a general practitioner (GP) last year to 3.07 (95% CI 2.00–4.73) in people who reported poor subjective health. The OR associated with physical impairment and mental impairment was 2.69 (95% CI 1.75–4.14) and 2.49 (95% CI 1.31–4.74), respectively. Analysis of reporting both whiplash and neck pain gave somewhat stronger association, with ORs varying from 1.50 (95% CI 1.07–2.09) in people visiting a GP last year to 5.70 (95% CI 3.18–10.23) in people reporting poor subjective health. Physical impairment was associated with an OR of 3.48 (95% CI 2.12–5.69) and mental impairment with an OR of 3.02 (95% CI 1.46–6.22).

Conclusion

Impaired self-reported pre-injury health was strongly associated with the reporting of a whiplash trauma, especially in conjunction with neck pain. This may indicate that individuals have, already before the trauma, adopted an illness role or behaviour which is extended into and influence the report of a whiplash injury. The finding is in support of a functional somatic disorder model for whiplash.

Keywords

Whiplash Whiplash and neck pain Longitudinal study Population study Pre-injury health 

Notes

Acknowledgments

AM was funded by The Norwegian Research Council. No further support was received. The HUNT study is a collaboration between the HUNT Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, The Norwegian Institute of Public Health, and Nord-Trøndelag County Council.

Conflict of interest

None.

References

  1. 1.
    Wenzel HG, Mykletun A, Nilsen TIL (2009) Symptom profile of persons self-reporting whiplash: a Norwegian population-based study (Hunt 2). Eur Spine J 18:1363–1370PubMedCrossRefGoogle Scholar
  2. 2.
    Borchgrevink G, Smevik O, Haave I, Haraldseth O, Nordby A, Lereim I (1997) MRI of cerebrum and cervical columna within 2 days after whiplash neck sprain injury. Injury 28(5–6):331–335PubMedCrossRefGoogle Scholar
  3. 3.
    Chappuis G, Soltermanna B (2008) Number and cost of claims linked to minor cervical trauma in Europe: results from the comparative study by cea, aredoc and ceredoc. Eur Spine J 17:1350–1357PubMedCrossRefGoogle Scholar
  4. 4.
    Holm LW, Carroll LJ, Cassidy JD, Hogg-Johnson S, Coté P, Guzman J, Peloso P, Nordin M, van der Velde G, Carragee E, Halderman S (2008) 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. Spine 33(45):S52–S59PubMedCrossRefGoogle Scholar
  5. 5.
    Carroll LJ, Holm LW, Hogg-Johnson S, Coté P, Cassidy JD, Halderman S, Nordin M, Hurwitz EL, Carragee EJ, van der Velde G, Peloso PM, Guzman J (2008) 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. Spine 33((S4)):S83–S92PubMedCrossRefGoogle Scholar
  6. 6.
    Binder A (2007) The diagnosis and treatment of nonspecific neck pain and whiplash. Eura Medicophys 43:79–89PubMedGoogle Scholar
  7. 7.
    Coté P, Cassidy JD, Carroll LJ, Frank JW, Bombardier C (2001) A systematic review of the prognosis of acute whiplash and a new conceptual framework to synthesize the literature. Spine 26(19):E445–E458PubMedCrossRefGoogle Scholar
  8. 8.
    Holm LW, Carroll LJ, Cassidy JD, Skillgate E, Ahlbom A (2008) Expectations for recovery important in the prognosis of whiplash injuries. PLoS Med 5(5):e105PubMedCrossRefGoogle Scholar
  9. 9.
    Sullivan MJL, Stanish W, Sullivan ME, Tripp D (2002) Differential predictors of pain and disability in patients with whiplash injuries. Pain Res Manage 7(2):68–74Google Scholar
  10. 10.
    Buitenhuis J, Spanjer J, Fidler V (2003) Recovery from acute whiplash. The role of coping styles. Spine 28(9):896–901PubMedGoogle Scholar
  11. 11.
    Hendriks EJM, Scholten-Peeters GGM, Van der Windt DA, Neeleman-van der Steen CWM, Oostendorp RAB, Verhagen AP et al (2005) Prognostic factors for poor recovery in acute whiplash patients. Pain 114(1–2):408–416PubMedCrossRefGoogle Scholar
  12. 12.
    Holm LW, Carroll LJ, Cassidy JD, Ahlbom A (2007) Factors influencing neck pain intensity in whiplash-associated disorders in Sweden. Clin J Pain 27(7):591–597Google Scholar
  13. 13.
    Kivioja J, Jensen I, Lindgren U (2008) Neither the wad-classification nor the Quebec task force follow-up regiment seems to be important for the outcome after a whiplash injury. A prospective study on 186 consecutive patients. Eur Spine J 17:930–935PubMedCrossRefGoogle Scholar
  14. 14.
    Holmen J, Midthjell K, Bjartveit K, Hjort PF, Lund-Larsen PG, Mooun T, Næss S, Waalder H, Th. (1990) The Nord-Trøndelag health survey 1984–86. Purpose, background and methods. Participation, non-participation and frequency distributions. Report 4/90. HUNT Research CentreGoogle Scholar
  15. 15.
    Holmen J, Midthjell K, Krüger Ø, Langhammer A, Holmen T, Bratberg G, Vatten L, Lund-Larsen P (2003) The Nord-Trøndelag health study 1995–97 (HUNT 2): objectives, contents, methods and participation. Norsk Epidemiol 13:19–32Google Scholar
  16. 16.
    Berglund A, Bodin L, Jensen I, Wiklund A, Alfredsson L (2006) The influence of prognostic factors on neck pain intensity, disability, anxiety and depression over a 2-year period in subjects with acute whiplash injury. Pain 125(3):244–256PubMedCrossRefGoogle Scholar
  17. 17.
    Scholten-Peeters GG, Verhagen AP, Bekkering GE, Van der Windt DA, Barnsley L, Oosendorp RAB, Hendriks EJM et al (2003) Prognostic factors of whiplash-associated disorders: a systematic review of prospective cohort studies. Pain 104(1–2):303–322PubMedCrossRefGoogle Scholar
  18. 18.
    Hunter J (2001) Demographic variables and chronic pain. Clin J Pain 17(4 Suppl):S14–S19PubMedCrossRefGoogle Scholar
  19. 19.
    Williams M, Williamson E, Gates S, Lamb SE, Cooke M (2007) A systematic literature review of physical prognostic factors for the development of late whiplash syndrome. Spine 32(25):E764–E780PubMedCrossRefGoogle Scholar
  20. 20.
    Ferrari R, Russell AS, Carroll LJ, Cassidy JD (2005) A re-examination of the whiplash associated disorders (WAD) as a systemic illness. Ann Rheum Dis 64:1337–1342PubMedCrossRefGoogle Scholar
  21. 21.
    Carragee EJ (2008) Validity of self-reported history in patients with acute back or neck pain after motor vehicle accidents. Spine J 8(2):311–319PubMedCrossRefGoogle Scholar
  22. 22.
    Lankester BJA, Garneti N, Gargan MF, Bannister GC (2006) Factors predicting outcome after injury in subjects pursuing litigation. Eur Spine J 15(6):902–907PubMedCrossRefGoogle Scholar
  23. 23.
    Turner MA, Taylor PJ, Neal LA (2003) Physical and psychiatric predictors of late whiplash syndrome. Injury 34(6):434–437PubMedCrossRefGoogle Scholar
  24. 24.
    McLean SA, Clauw DJ (2004) Predicting chronic symptoms after an acute “stressor”—lessons learned from 3 medical conditions. Med Hypotheses 63(4):653–658PubMedCrossRefGoogle Scholar
  25. 25.
    Barsky AJ, Borus JF (1999) Functional somatic syndromes. Ann Int Med 130:910–921PubMedGoogle Scholar
  26. 26.
    Mykletun A, Glozier N, Wenzel HG, Øverland S, Harvey SB, Wessely S, Hotopf M (2011) Reverse causality in the association between whiplash and anxiety and depression. The HUNT study. Spine 36(17):1380–1386PubMedCrossRefGoogle Scholar
  27. 27.
    Wenzel HG, Haug TT, Mykletun A, Dahl AA (2002) A population study of anxiety and depression among persons who report whiplash traumas. J Psychosom Res 53(3):831–835PubMedCrossRefGoogle Scholar
  28. 28.
    Hogg-Johnson S, van der Velde G, Carroll LJ, Holm LW, Cassidy JD, Guzman J, Coté P, Halderman S, Ammendolia C, Carragee E, Hurwitz E, Nordin M, Peloso P (2008) The burden and determinants of neck pain in the general population: results of the bone and joint decade 2000–2010 task force on neck pain and its associated disorders. Spine 33(4S):S39–S51PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Hanne Gro Wenzel
    • 1
    • 2
  • Ottar Vasseljen
    • 1
  • Arnstein Mykletun
    • 3
    • 4
  • Tom Ivar Lund Nilsen
    • 5
  1. 1.Department of Public Health and General PracticeFaculty of Medicine, Norwegian University of Science and TechnologyTrondheimNorway
  2. 2.Division of Psychiatry, Orkdal DepartmentSt Olav University HospitalOrkangerNorway
  3. 3.Research Centre for Health Promotion, Faculty of PsychologyUniversity of BergenBergenNorway
  4. 4.Division of Mental HealthNorwegian Institute of Public HealthOsloNorway
  5. 5.Department of Human Movement ScienceNorwegian University of Science and TechnologyTrondheimNorway

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