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Development in pain and neurologic complaints after whiplash

2003; Lippincott Williams & Wilkins; Volume: 60; Issue: 5 Linguagem: Inglês

10.1212/01.wnl.0000046661.82212.04

1526-632X

Helge Kasch, Flemming W. Bach, Kristian Stengaard‐Pedersen, Troels S. Jensen,

Cardiac Arrest and Resuscitation

Objective: To prospectively examine the course of pain and other neurologic complaints in patients with acute whiplash injury and in controls with acute ankle injury. Methods: Patients with acute whiplash (n = 141) and ankle-injured controls (n = 40) were consecutively sampled, and underwent interview and examination after 1 week and 1, 3, 6, and 12 months. Outcome measures were pain intensity, pain frequency, and associated symptoms. Results: Initial overall pain intensity above lower extremities (pain in neck, head, shoulder-arm, and low back) was similar in patients with whiplash (median Visual Analogue Scale [VAS] 0–100 of 20 [25th and 75th percentile, 4, 39]) and ankle-injured controls (median VAS 0–100 of 15 [5, 34]). Whiplash-injured patients reported median overall VAS 0–100 pain intensity above lower extremities of 23 (12, 40) after 11 days and 14 (12, 40) after 1 year. Controls reported pain intensity of 0 (0, 4) after 12 days and 0 (0, 9) after 1 year. Reported overall pain frequency above lower extremities was 96% after 11 days and 74% after 1 year in whiplash-injured patients and 33% after 12 days and 47% after 1 year in controls. Associated neurologic symptoms were two to three times more common after whiplash injury. Correlation was found between pain intensity and associated symptoms in whiplash-injured patients but not controls. Conclusion: Pain occurs with high frequency but low intensity after whiplash and ankle injury. Associated neurologic symptoms were not correlated to pain in ankle-injured controls, but were correlated to pain in patients with whiplash injury. Persistent symptoms in whiplash-injured patients may be caused by both specific neck injury–related factors and nonspecific post-traumatic reactions. Disability was only encountered in the whiplash group.