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Whiplash: What Predicts Recovery?

Pain Level, State of Mind Important; Neck Collars Not Helpful, Research Shows
By
WebMD Health News
Reviewed by Louise Chang, MD

Jan. 22, 2008 -- The initial level of pain after a whiplash injury, as well as psychological factors such as having positive expectations for getting better, best predict who will recover promptly from whiplash, according to research presented this week at the World Congress on Neck Pain in Los Angeles.

Researchers also released task force findings on the best assessment and treatment of whiplash and other neck pain.

Whiplash is an injury to the neck that usually occurs because of sudden extension and flexion, often during an auto accident. Most whiplash victims recover in a few months, but many report recurring pain a year or more later.

Whiplash is reported in about 2 million insurance claims per year in the U.S., according to the Insurance Institute for Highway Safety. Recently, researchers have begun to focus more on predictors of recovery.

Whiplash Recovery: Initial Pain as a Predictor

The level of pain three weeks after a whiplash injury is "the single most important predictor of who recovers in a timely manner," says David Walton, PT, a researcher at The University of Western Ontario in London, Ontario, Canada. He reviewed 14 published studies including more than 3,000 whiplash patients and presented his findings at the Congress.

Those who rate their pain as less than 5 on a commonly used 10-point pain scale are more likely to recover quickly, he tells WebMD.

Whiplash Recovery: Expectations Count

A person's expectations of recovery from whiplash also matter, says Lena Holm, DrMedSc, a research fellow at the Institute of Environmental Medicine at Karolinska Institutet in Stockholm, Sweden.

With her colleagues, she evaluated the recovery expectations of more than 1,000 insurance claimants who filed a neck injury claim after a car collision to one of two insurance companies in Sweden between January 2004 and January 2005.

Three weeks after the injury, Holm's team asked the claimants how likely they felt they would recover fully. At six months, they compared the disability level of the participants with expectations.

"Expectations had a big impact," she tells WebMD, even after adjusting for physical symptoms and other factors. Those who felt initially that they wouldn't make a full recovery were more than four times as likely to be in the group of the "more disabled" participants at six months than those who felt more positively about their chances for a recovery, she says.

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