Whiplash: What Predicts Recovery?
Pain Level, State of Mind Important; Neck Collars Not Helpful, Research Shows
Other Predictors of Recovery
Those prone to catastrophic thinking also fare poorly, Walton found in his
analysis of 14 studies.
"These are the people who can't get the pain out of their mind, who
believe this is the worst thing that has ever happened to them," he
Feeling down or blue immediately after a whiplash injury is common, says
Leah Phillips, a PhD student and researcher at the University of Alberta,
Edmonton, Canada. The depressed feeling is more likely to persist in those
under age 50 with less education and income, she found in a survey of nearly
5,500 adults in Saskatchewan who had suffered whiplash injuries between 1997
Those who had more initial neck pain and low back
pain, as well as higher levels of anxiety right after the injury, were also more likely to
keep reporting the depressed feeling during the one-year follow-up, she
She wasn't measuring true clinical
depression, she says, but asked at each follow up whether the patients had
a depressed mood. "It could develop into clinical depression," she
Whiplash Treatment: Neck Collar Treatment Not Helpful
Wearing a neck collar to immobilize the area after whiplash injury is
outdated, says Sylvia Schick, MD, MPH, a researcher at the Institute for Legal
Medicine at Ludwig Maximilians Universitat in Munich, Germany.
Many physicians still prescribe the device, Schick says, but her comparison
study of those who wore the collar with those who did not shows it is not
Using the data base of a large insurance company in Germany, Schick and her
colleagues compared the results of 31 whiplash patients treated without a neck
collar and 40 with the neck collar. Both groups got about the same length and
quality of treatment, she says, although those treated with the collar were
also more likely to get pain-killing drugs.
No differences were found between groups in reports of neck pain or
stiffness, she says. Those who wore the collar actually were absent longer from
work than those who did not wear it. One study limitation, says Schick, was
lack of information about how long the collars were worn.