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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

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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.

Study Design

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.

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Author information

Authors and Affiliations

  1. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

    Lena W. Holm DrMedSc

  2. Department of Public Health Sciences, and the Alberta Centre for Injury Control and Research, School of Public Health, University of Alberta, Alberta, Canada

    Lena W. Holm DrMedSc & Linda J. Carroll PhD

  3. Centre of Research Expertise in Improved Disability Outcomes (CREIDO), University Health Network Rehailitation Solutions, Toronto, Canada

    J. David Cassidy DC, PhD, DrMedSc

  4. Division of Health Care and Outcomes Research, Toronto Western Research Institute, Toronto, Canada

    Lena W. Holm DrMedSc, J. David Cassidy DC, PhD, DrMedSc & Gabrielle van der Velde DC

  5. Departments of Public Health Sciences and Health Policy, Managemen tand Evaluation, University of Toronto, Toronto, Canada

    J. David Cassidy DC, PhD, DrMedSc

  6. Institute for Work and Health, Department of Public Health Sciences, University of Toronto, Toronto, Canada

    Sheilah Hogg-Johnson PhD

  7. Departments of Public Health Sciences and Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada

    Pierre Côté DC, PhD

  8. Division of Health Care and Outcomes Research, Toronto Western Research Institute, Toronto, Canada

    Pierre Côté DC, PhD

  9. Centre of Research Expertise in Improved Disability Outcomes (CREIDO), University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, Canada

    Pierre Côté DC, PhD

  10. Institute for Work & Health, Toronto, Canada

    Pierre Côté DC, PhD

  11. Department of Medicine, University of British Columbia; Occupational Health and Safety Agency for Health care in BC, Columbia, Canada

    Jamie Guzman MD, MSc, FRCP(C)

  12. Endocrinology, Analgesia and Inflammation, Merck & Co, Rahway, NJ, USA

    Paul Peloso MD, MSc, FRCP(C)

  13. Departments of Orthopaedics and Environmental Medicine and Program of Ergonomics and Biomechanics, School of Medicine and Graduate School of Arts and Science, NewYork University, NewYork, NY, USA

    Margareta Nordin PT, DrMedSc

  14. Occupational and Industrial Orthopaedic Center(OIOC), NewYork University Medical Center, NewYork, NY, USA

    Margareta Nordin PT, DrMedSc

  15. Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii

    Eric Hurwitz DC, PhD

  16. Institute for Work and Health, Toronto, Canada

    Gabrielle van der Velde DC

  17. Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada

    Gabrielle van der Velde DC

  18. Centre of Research Excellence in Improved Disability Outcomes(CREIDO), University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, Canada

    Gabrielle van der Velde DC

  19. Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, USA

    Eugene Carragee MD, FACS

  20. Orthopaedic Spine Center and Spinal Surgery Service, Stanford University Hospital and Clinics, Stanford, USA

    Eugene Carragee MD, FACS

  21. Department of Neurology, University of California, Irvine, CA, USA

    Scott Haldeman MD, PhD

  22. Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA

    Scott Haldeman MD, PhD

Authors
  1. Lena W. Holm DrMedSc
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  2. Linda J. Carroll PhD
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  3. J. David Cassidy DC, PhD, DrMedSc
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  4. Sheilah Hogg-Johnson PhD
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  5. Pierre Côté DC, PhD
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  6. Jamie Guzman MD, MSc, FRCP(C)
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  7. Paul Peloso MD, MSc, FRCP(C)
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  8. Margareta Nordin PT, DrMedSc
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  9. Eric Hurwitz DC, PhD
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  10. Gabrielle van der Velde DC
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  11. Eugene Carragee MD, FACS
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  12. Scott Haldeman MD, PhD
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Corresponding author

Correspondence to Lena W. Holm DrMedSc.

Additional information

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.

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Holm, L.W., Carroll, L.J., Cassidy, J.D. et al. The Burden and Determinants of Neck Pain in Whiplash-Associated Disorders After Traffic Collisions. Eur Spine J 17 (Suppl 1), 52–59 (2008). https://doi.org/10.1007/s00586-008-0625-x

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  • DOI: https://doi.org/10.1007/s00586-008-0625-x

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