Journal of Manipulative and Physiological Therapeutics
Volume 32, Issue 2, Supplement , Pages S61-S69, February 2009

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

  • Lena W. Holm, DrMedSc

      Affiliations

    • Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
    • Corresponding Author InformationAddress correspondence and reprint requests to Lena W. Holm, DrMedSc, Institute of Environmental Medicine, Division of Epidemiology, Karolinska Institutet, PO Box 210, SE-171 77 Stockholm, Sweden
    • ,
  • Linda J. Carroll, PhD

      Affiliations

    • Department of Public Health Sciences, and the Alberta Centre for Injury Control and Research, School of Public Health, University of Alberta, Canada
    • ,
  • J. David Cassidy, DC, PhD, DrMedSc

      Affiliations

    • Centre of Research Expertise in Improved Disability Outcomes (CREIDO), University Health Network Rehabilitation Solutions, Toronto, Canada; Division of Health Care and Outcomes Research, Toronto Western Research Institute, Toronto, Canada; Departments of Public Health Sciences and Health Policy, Management and Evaluation, University of Toronto, Canada
    • ,
  • Sheilah Hogg-Johnson, PhD

      Affiliations

    • Institute for Work and Health, Toronto; Department of Public Health Sciences, University of Toronto, Canada
    • ,
  • Pierre Côté, DC, PhD

      Affiliations

    • Departments of Public Health Sciences and Health Policy, Management and Evaluation, University of Toronto, Canada; Division of Health Care and Outcomes Research, Toronto Western Research Institute, Toronto, Canada; Centre of Research Expertise in Improved Disability Outcomes (CREIDO), University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, Canada; Institute for Work & Health, Toronto, Canada
    • ,
  • Jamie Guzman, MD, MSc, FRCP(C)

      Affiliations

    • Department of Medicine, University of British Columbia; Occupational Health and Safety Agency for Healthcare in BC, Canada
    • ,
  • Paul Peloso, MD, MSc, FRCP(C)

      Affiliations

    • Endocrinology, Analgesia and Inflammation, Merck & Co. Rahway, NJ
    • ,
  • Margareta Nordin, PT, DrMedSc

      Affiliations

    • Departments of Orthopaedics and Environmental Medicine and Program of Ergonomics and Biomechanics, School of Medicine and Graduate School of Arts and Science, New York University, New York, NY; Occupational and Industrial Orthopaedic Center (OIOC), New York University Medical Center, New York, NY
    • ,
  • Eric Hurwitz, DC, PhDh

      Affiliations

    • Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii at Mānoa, Honolulu, Hawaii
    • ,
  • Gabrielle van der Velde, DC

      Affiliations

    • Institute for Work and Health, Toronto, Canada; Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada; Division of Health Care and Outcomes Research, Toronto Western Research Institute, Toronto, Canada; Centre of Research Excellence in Improved Disability Outcomes (CREIDO), University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, Canada
    • ,
  • Eugene Carragee, MD, FACS

      Affiliations

    • Department of Orthopaedic Surgery, Stanford University School of Medicine; Orthopaedic Spine Center and Spinal Surgery Service, Stanford University Hospital and Clinics
    • ,
  • Scott Haldeman, MD, PhD

      Affiliations

    • Department of Neurology, University of California, Irvine, CA; Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA

Abstract 

Study Design

Best evidence synthesis.

Objective

To undertake a best evidence synthesis on the burden and determinants of whiplash-associated disorders (WAD) after traffic collisions.

Summary of Background Data

Previous best evidence synthesis on WAD has noted a lack of evidence regarding incidence of and risk factors for WAD. Therefore there was a warrant of a reanalyze of this body of research.

Methods

A systematic search of Medline was conducted. The reviewers looked for studies on neck pain and its associated disorders published 1980–2006. Each relevant study was independently and critically reviewed by rotating pairs of reviewers. Data from studies judged to have acceptable internal validity (scientifically admissible) were abstracted into evidence tables, and provide the body of the best evidence synthesis.

Results

The authors found 32 scientifically admissible studies related to the burden and determinants of WAD. In the Western world, visits to emergency rooms due to WAD have increased over the past 30 years. The annual cumulative incidence of WAD differed substantially between countries. They found that occupant seat position and collision impact direction were associated with WAD in one study. Eliminating insurance payments for pain and suffering were associated with a lower incidence of WAD injury claims in one study. Younger ages and being a female were both associated with filing claims or seeking care for WAD, although the evidence is not consistent. Preliminary evidence suggested that headrests/car seats, aimed to limiting head extension during rear-end collisions had a preventive effect on reporting WAD, especially in females.

Conclusion

WAD after traffic collisions affects many people. Despite many years of research, the evidence regarding risk factors for WAD is sparse but seems to include personal, societal, and environmental factors. More research including, well-defined studies with accurate denominators for calculating risk, and better consideration of confounding factors, are needed.

Key words: neck injury, whiplash-associated disorders, traffic collision, systematic review, epidemiology

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 The manuscript submitted does not contain information about medical device(s)/drug(s).

 Corporate/Industry, Foundation, and Professional Organizational funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

 Reprinted from Holm LW et al. 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 2008;33:S52-S59. Reprinted with permission from Lippincott Williams & Wilkins.

PII: S0161-4754(08)00338-2

doi:10.1016/j.jmpt.2008.11.011

Journal of Manipulative and Physiological Therapeutics
Volume 32, Issue 2, Supplement , Pages S61-S69, February 2009

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