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Whiplash Prognosis: Which Patients Are at Risk?

It’s a fact: one out of three people in rear-end auto collisions will experience some kind of chronic pain. The problem, though, is predicting who these long-term sufferers will be so that they can get the early care they need.

A new study from leading whiplash researchers provides some tips on identifying those patients at risk.

The authors followed 688 patients who had been in a frontal or rear-end collision and had exhibited whiplash symptoms within three days of the crash. Each of the patients was evaluated with a thorough neurological exam, and evaluated for cervical range of motion (CROM) and intensity of pain levels. Based on these criteria, the patients were categorized as “high” or “low” risk; the patient was unaware of being placed in either group. The patients were again evaluated at two weeks, three months, and 12 months after injury.

The study found the following predicted slower recovery:

  • Reduced CROM
  • High neck pain and headache intensity
  • The presence of non-painful symptoms, such as: cognitive symptoms, fatigue, irritability, problems with concentration, and sleep disturbances.

The authors conclude that patients with this pattern of symptoms had a 10 times higher risk of developing chronic pain from their injury. These patients should be evaluated and treated as soon as possible after an injury to prevent long-term consequences.

Kasch H, Qerama E, Kongstad A, et al. Clinical assessment of prognostic factors for long-term pain and handicap after whiplash injury: a 1-year prospective study. European Journal of Neurology 2008;15:1222-1230.