Predicting Two or Three Year Outcome of Whiplash InjuryPredicting who might have a poor outcome after a whiplash injury is the topic of this study. Patients with acute whiplash injury were included.
In a previous study these same researchers showed that pain and disability levels at the time of the accident weren't enough to predict symptoms six months later. Both physical and psychologic factors were important predictors. More information was needed to guide early treatment. They continued following this same group of patients for another two to three years.
They found that older age, reduced cold pain tolerance, and symptoms of post-traumatic stress syndrome (PTSB) were good predictors of future moderate-to-severe pain levels. More than half the patients had neck pain, headaches, and shoulder/arm pain six months after the accident. Almost 80 percent of those patients were still the same two years later. Only a small group recovered completely. The rest of the remaining 20 percent had mild improvement.
The authors conclude that it may be possible to predict which whiplash patients will fail to recover. Physical and psychologic changes noticed one month after the accident were still present six months later. The same symptoms were still present two or three years later.
Whiplash patients should be assessed right away for the presence of these predictive risk factors. Early management to prevent chronic pain is advised. Treatment should include many options such as drugs for pain management, physical therapy, and counseling.
Michele Sterling, et al. Physical and Psychological Factors Maintain Long-Term Predictive Capacity Post-whiplash Injury. In Pain. May 2006. Vol. 122. No. 1-2. Pp. 102-108.
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