Journal of Manipulative and Physiological Therapeutics
Volume 32, Issue 2, Supplement , Pages S97-S107, February 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

  • Linda J. Carroll, PhD

      Affiliations

    • Department of Public Health Sciences, School of Public Health, University of Alberta, Canada
    • The Alberta Centre for Injury Control and Research, School of Public Health, University of Alberta, Canada
    • Corresponding Author InformationAddress correspondence and reprint requests to Linda J. Carroll, 4075 RTF, University of Alberta, Edmonton, Alberta, Canada T6G 2E1
    • ,
  • Lena W. Holm, DrMedSc

      Affiliations

    • Institute of Environmental Medicine, Karolinska Institutet, Sweden
    • ,
  • Sheilah Hogg-Johnson, PhD

      Affiliations

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

      Affiliations

    • Institute for Work and Health, Toronto, Canada
    • Departments of Public Health Sciences, and Health Policy, Management and Evaluation, University of Toronto, Canada
    • Centre of Research Expertise in Improved Disability Outcomes (CREIDO), University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, Canada
    • Division of Health Care and Outcomes Research, Toronto Western Research Institute, Toronto, Canada
    • ,
  • J. David Cassidy, DC, PhD, DrMedSc

      Affiliations

    • Departments of Public Health Sciences, and Health Policy, Management and Evaluation, University of Toronto, Canada
    • Centre of Research Expertise in Improved Disability Outcomes (CREIDO), University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, Canada
    • Division of Health Care and Outcomes Research, Toronto Western Research Institute, Toronto, Canada
    • ,
  • Scott Haldeman, DC, MD, PhD

      Affiliations

    • Department of Neurology, University of California, Irvine, CA
    • Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA
    • ,
  • Margareta Nordin, PT, DrMedSc

      Affiliations

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

      Affiliations

    • Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii at Mānoa, Honolulu, HI
    • ,
  • Eugene J. Carragee, MD, FACS

      Affiliations

    • Department of Orthopaedic Surgery, Stanford University School of Medicine, Standford, CA
    • Orthopaedic Spine Center and Spinal Surgery Service, Stanford University Hospital and Clinics, Standford, CA
    • ,
  • Gabrielle van der Velde, DC

      Affiliations

    • Institute for Work and Health, Toronto, Canada
    • Centre of Research Expertise in Improved Disability Outcomes (CREIDO), University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, Canada
    • Division of Health Care and Outcomes Research, Toronto Western Research Institute, Toronto, Canada
    • Department of Health Policy, Management and Evaluation, University of Toronto, Canada
    • ,
  • Paul M. Peloso, MD, MSc, FRCP(C)

      Affiliations

    • Endocrinology, Analgesia and Inflammation, Merck and Co. Rahway, NJ
    • ,
  • Jaime Guzman, MD, MSc, FRCP(C)

      Affiliations

    • Department of Medicine, University of British Columbia, Canada
    • Occupational Health and Safety Agency for Healthcare in British Columbia, Canada

Abstract 

Study Design

Best evidence synthesis.

Objective

To perform a best evidence synthesis on the course and prognostic factors for neck pain and its associated disorders in Grades I–III whiplash-associated disorders (WAD).

Summary of Background Data

Knowledge of the course of recovery of WAD guides expectations for recovery. Identifying prognostic factors assists in planning management and intervention strategies and effective compensation policies to decrease the burden of WAD.

Methods

The Bone and Joint Decade 2000–2010 Task Force on Neck Pain and its Associated Disorders (Neck Pain Task Force) conducted a critical review of the literature published between 1980 and 2006 to assemble the best evidence on neck pain and its associated disorders. Studies meeting criteria for scientific validity were included in a best evidence synthesis.

Results

We found 226 articles related to course and prognostic factors in neck pain and its associated disorders. After a critical review, 70 (31%) were accepted on scientific merit; 47 of these studies related to course and prognostic factors in WAD. The evidence suggests that approximately 50% of those with WAD will report neck pain symptoms 1 year after their injuries. Greater initial pain, more symptoms, and greater initial disability predicted slower recovery. Few factors related to the collision itself (for example, direction of the collision, headrest type) were prognostic; however, postinjury psychological factors such as passive coping style, depressed mood, and fear of movement were prognostic for slower or less complete recovery. There is also preliminary evidence that the prevailing compensation system is prognostic for recovery in WAD.

Conclusion

The Neck Pain Task Force undertook a best evidence synthesis to establish a baseline of the current best evidence on the course and prognosis for WAD. Recovery of WAD seems to be multifactorial.

Key words: neck pain, systematic review, epidemiology, prognosis, whiplash

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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 Carroll LJ et al. 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. Spine 2008;33:S83-92. Reprinted with permission from Lippincott Williams & Wilkins.

PII: S0161-4754(08)00341-2

doi:10.1016/j.jmpt.2008.11.014

Journal of Manipulative and Physiological Therapeutics
Volume 32, Issue 2, Supplement , Pages S97-S107, February 2009

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