Impact of motor vehicle accidents on neck pain and disability in general practice
From: Br J Gen Pract. 2008 Sep;58(554):624-9
High levels of continuous neck pain after a motor vehicle accident are reported in cross-sectional studies. Knowledge of this association in general practice is limited. To compare the differences in perceived pain and disability in patients with acute neck pain due to a motor vehicle accident versus other self-reported causes. The secondary aim was to identify prognostic factors for continuous neck pain.
Prospective cohort study with 1-year follow-up. General practices in Rotterdam and its suburban region with non-specific acute neck pain were invited to participate. Questionnaires were collected at baseline and after 6, 12, 26, and 52 weeks. The numerical pain-rating scale and the neck disability index were measured. Regression analysis was used to identify prognostic factors for continuous neck pain.
A total of 187 patients were included. The motor vehicle accident subgroup (n = 42) was significantly younger, reported more sick leave, higher levels of headache and higher neck disability index scores at baseline but lower scores for previous neck pain compared to the remaining cohort. At follow-up the motor vehicle accident subgroup had higher scores for continuous neck pain (63% versus 40%) and at the neck disability index (11.0 versus 7.1). After multivariate analysis pain in the upper part of the neck, duration of complaints at baseline longer than 2 weeks, and a motor vehicle accident were significantly correlated with outcome. Individuals exposed to motor vehicle accidents constitute a relevant subgroup of patients with neck pain. A motor vehicle accident and a longer duration of complaints are prognostic factors for continuous neck pain.
