Skip to main content

Comparison of Motor Vehicle Accident (MVA) Survivors and Non-MVA Pain Patients Attending an Interdisciplinary Pain Management Program


Soft tissue injuries (STI) arising from motor vehicle accidents (MVA) are significant cause of chronic pain, disability, and cost in patients. This study compares demographics and outcomes of MVA and non-MVA patients attending a community-based interdisciplinary pain management program funded by the Ontario Ministry of Health. This descriptive, cross-sectional practice-based retrospective study was conducted on 121 consecutive patients, screened for motivation and commitment, and admitted to an intense 3-month pain management program during 2016–2018 (MVA n = 31 and non-MVA n = 90). Data collected included: (a) demographics; (b) pain characteristics; (c) physical and emotional health status obtained by validated instruments, and (d) social outcomes regarding work or school obtained via retrospective chart review. Means of pre- and post-program variables (baseline and upon program exit) were compared to assess effectiveness of treatment in both groups. At baseline, the MVA group was more likely to have a lawyer; included more women; had shorter duration of pain complaints; and higher scores in Kinesiophobia (TSK), anxiety (GAD) and depression (CES-D). Upon program exit, MVA patients had improved by 29–60% and non-MVA patients by 32–57% in pain catastrophizing, self-efficacy, pain interference and severity scores, kinesiophobia, anxiety and depression, while both groups improved substantially in their social health status 6 and/or 12 months after program exit. Despite the presence of litigation, well-selected MVA patients attending a community-based interdisciplinary pain management program can obtain substantial improvement across several domains, almost equal to that obtained by non-MVA patients with chronic pain.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

Availability of data and material

Data not available because patients’ participants’ information, privacy, and confidentiality could be compromised.

Code Availability

Not Applicable.


  • American Pain Society White Paper: Interdisciplinary Pain Management. (2008).

  • Ameratunga, S. N., Norton, R. N., Bennett, D. A., & Jackson, R. T. (2004). Risk of disability due to car crashes: A review of the literature and methodological issues. Injury, 35(11), 1116–1127.

    Article  Google Scholar 

  • Angst, F., Verra, M. L., Lehmann, S., Brioschi, R., & Aeschlimann, A. (2009). Clinical effectiveness of an interdisciplinary pain management programme compared with standard inpatient rehabilitation in chronic pain: A naturalistic, prospective controlled cohort study. Journal of Rehabilitation Medicine, 41(7), 569–575.

    Article  Google Scholar 

  • Barnsley, L., Lord, S., & Bogduk, N. (1994). Whiplash injury. Pain, 58(3), 283-307.

  • Bosy, D., Etlin, D., Corey, D., & Lee, J. W. (2010). An interdisciplinary pain rehabilitation programme: Description and evaluation of outcomes. Physiotherapy Canada, 62(4), 316–326.

    Article  Google Scholar 

  • Canadian Association of Chiefs of Police Canada. (2020). Road Safety Week 2020–National Facts And Stats May 12–18, 2020 Accessed 04 JULY 2021.

  • Carroll, L. J., Holm, L. W., Hogg-Johnson, S., Côté, P., Cassidy, J. D., Haldeman, S., & Guzman, J. (2009). 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. Journal of Manipulative and Physiological Therapeutics, 32(2), S97–S107.

    Article  Google Scholar 

  • Cheatle, M. D. (2016). Biopsychosocial approach to assessing and managing patients with chronic pain. Medical Clinics, 100(1), 43–53.

    PubMed  Google Scholar 

  • Cleeland, C. S., & Ryan, K. M. (1994). Pain assessment: Global use of the Brief Pain Inventory. Annals, Academy of Medicine, Singapore.

  • Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196(4286), 129–136.

    Article  Google Scholar 

  • Finestone, H. M., Alfeeli, A., & Fisher, W. A. (2008). Stress-induced physiologic changes as a basis for the biopsychosocial model of chronic musculoskeletal pain: A new theory? The Clinical Journal of Pain, 24(9), 767–775.

    Article  Google Scholar 

  • Gatchel, R. J., McGeary, D. D., McGeary, C. A., & Lippe, B. (2014). Interdisciplinary chronic pain management: Past, present, and future. American Psychologist, 69(2), 119.

    Article  Google Scholar 

  • Geisser, M. E., Roth, R. S., & Robinson, M. E. (1997). Assessing depression among persons with chronic pain using the Center for Epidemiological Studies-Depression Scale and the Beck Depression Inventory: A comparative analysis. The Clinical Journal of Pain, 13(2), 163–170.

    Article  Google Scholar 

  • Giummarra, M. J., Ioannou, L., Ponsford, J., Cameron, P. A., Jennings, P. A., Gibson, S. J., & Georgiou-Karistianis, N. (2016). Chronic pain following motor vehicle collision. A systematic review of outcomes associated with seeking or receiving compensation. The Clinical Journal of Pain, 32(9), 817–827.

  • Gurumoorthy, D., & Twomey, L. (1996). The Quebec Task Force on Whiplash-Associated Disorders. Spine, 21(7), 897–898.

    Article  Google Scholar 

  • Guzmán, J., Esmail, R., Karjalainen, K., Malmivaara, A., Irvin, E., & Bombardier, C. (2001). Multidisciplinary rehabilitation for chronic low back pain: Systematic review. Bmjj, 322(7301), 1511–1516.

    Article  Google Scholar 

  • Harder, S., Veilleux, M., & Suissa, S. (1998). The effect of socio-demographic and crash-related factors on the prognosis of whiplash. Journal of Clinical Epidemiology, 51(5), 377–384.

    Article  Google Scholar 

  • Herrström, P., Lannerbro-geijer, G., & Högstedt, B. (2000). Whiplash injuries from car accidents in a Swedish middle-sized town during 1993–95. Scandinavian Journal of Primary Health Care, 18(3), 154–158.

    Article  Google Scholar 

  • Katz, L., Patterson, L., & Zacharias, R. (2019). Evaluation of an interdisciplinary chronic pain program and predictors of readiness for change. Canadian Journal of Pain, 3(1), 70–78.

    Article  Google Scholar 

  • Korri, S. H., Miller, R. P., & Todd, D. D. (1990). Kinesiophobia: A new view of chronic pain behaviour. Pain Manag, 3, 35–43.

    Google Scholar 

  • Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613.

    Article  Google Scholar 

  • Littleton, S. M., Cameron, I. D., Poustie, S. J., Hughes, D. C., Robinson, B. J., Neeman, T. E., & Smith, P. N. (2011). The association of compensation on longer-term health status for people with musculoskeletal injuries following road traffic crashes: Emergency department inception cohort study. Injury, 42(9), 927–933.

    Article  Google Scholar 

  • Lankester, B. J. A., Garneti, N., & Bannister, G. C. (2004). The classification of outcome following whiplash injury—A comparison of methods. European Spine Journal, 13(7), 605–609.

    Article  Google Scholar 

  • Mailis, A., & Lakha, S. F. (2019). From (Ontario Ministry of Health and Long-Term Care) policy to implementation: A retrospective look at a community-based patient-centered model of care for chronic pain. Canadian Journal of Pain, 3(1), 114–125.

    Article  Google Scholar 

  • Nicholas, M. K. (2007). The pain self-efficacy questionnaire: Taking pain into account. European Journal of Pain, 11(2), 153–163.

    Article  Google Scholar 

  • Ontario Health Claims Database HCDB Standard Report – 2018-H1 / (September 2018) Accessed July 04, 2021.

  • Oslund, S., Robinson, R. C., Clark, T. C., Garofalo, J. P., Behnk, P., Walker, B., ... & Noe, C. E. (2009, July). Long-term effectiveness of a comprehensive pain management program: Strengthening the case for interdisciplinary care. In Baylor University Medical Center Proceedings (Vol. 22, No. 3, pp. 211–214). Taylor & Francis.

  • Quinlan, K. P., Annest, J. L., Myers, B., Ryan, G., & Hill, H. (2004). Neck strains and sprains among motor vehicle occupants—United States, 2000. Accident Analysis & Prevention, 36(1), 21–27.

    Article  Google Scholar 

  • Samoborec, S., Ruseckaite, R., Ayton, D., & Evans, S. (2018). Biopsychosocial factors associated with non-recovery after a minor transport-related injury: A systematic review. PLoS One, 13(6), e0198352.

  • Schatman, M. E. (2012). Interdisciplinary chronic pain management: International perspectives. Pain: Clinical Updates, 20(7), 1–5.

  • Spitzer, W. O. (1995). Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: Redefining “whiplash” and its management. Spine, 20, 1S-73S.

    Article  Google Scholar 

  • Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097.

    Article  Google Scholar 

  • Stanos, S. (2012). Focused review of interdisciplinary pain rehabilitation programs for chronic pain management. Current Pain and Headache Reports, 16(2), 147–152.

    Article  Google Scholar 

  • Sullivan, M. J., Bishop, S. R., & Pivik, J. (1995). The pain catastrophizing scale: Development and validation. Psychological Assessment, 7(4), 524.

    Article  Google Scholar 

  • Styrke, J., Stålnacke, B. M., Bylund, P. O., Sojka, P., & Björnstig, U. (2012). A 10-year incidence of acute whiplash injuries after road traffic crashes in a defined population in northern Sweden. PM&R, 4(10), 739–747.

    Article  Google Scholar 

  • Svestkova, O. (2008). International classification of functioning, disability and health of World Health Organization (ICF). Prague Medical Report, 109(4), 268–274.

    PubMed  Google Scholar 

  • Turk, D. C., Dworkin, R. H., Allen, R. R., Bellamy, N., Brandenburg, N., Carr, D. B., & Witter, J. (2003). Core outcome domains for chronic pain clinical trials: IMMPACT recommendations. Pain, 106(3), 337–345.

    Article  Google Scholar 

  • Wismans, K. S. H. M., & Huijkens, C. G. (1994). Incidentie en prevalentie van het ‘whiplash’-trauma. TNO report, 94.

  • World Health Organization. World report on disability 2011. Accessed July 04, 2021.

  • World Health Organization (WHO): ICF – International Classification of Functioning, Disability and Health. Geneva: World Health Organization; 2001, p. 10–20.

Download references

Author information

Authors and Affiliations



All authors discussed the consequences and implications and commented on the manuscript at all stages. All authors have approved the manuscript, and agree with its submission to Psychology and Injury Law.

Corresponding author

Correspondence to S. F. Lakha.

Ethics declarations

Ethics approval and consent to participate

The study was reviewed and approved by the University of Toronto Human Ethics Research Committee (Protocol ##36,903). Statement included in the method section. All patients had freely given informed consent to participate in the study. Informed consent statement included in the method section.

Consent for publication

Written informed consent for publication of their clinical details was obtained from the patients.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Lakha, S.F., Hapidou, E.G., Robinson, J. et al. Comparison of Motor Vehicle Accident (MVA) Survivors and Non-MVA Pain Patients Attending an Interdisciplinary Pain Management Program. Psychol. Inj. and Law (2022).

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI:


  • Motor Vehicle Accident (MVA)
  • Soft Tissue Injury (STI)
  • Pain
  • Litigation
  • Outcome measures
  • Prognosis