A study of chronic neck pain following whiplash injury

Graduation date: 1998This thesis is presented in five chapters. The first and fifth chapters are an introduction and summary. The second chapter, A Comprehensive Review of the Literature Relating to Chronic Neck Pain and Whiplash Injuries, reports the results of a review of the relevant literature. In the first section, commonly used terms are reviewed and defined. The subsequent section reports on the literature regarding the nature of traffic accidents in the United States. Next is a section on the epidemiology of non-fatal motor vehicle accident (MVA) induced injuries in the U.S.. The proceeding section presents the methods and results of an estimation of the incident rate of whiplash for 1995. The next section is a review of the literature related to late whiplash. A meta-analysis of this literature yielded an estimated cumulative incidence of late whiplash of 33% of all whiplash-injured individuals at 33 months. The final section is a report of the economic and public health impact of motor vehicle accidents. The third chapter, "Whiplash Associated Disorders (WAD) - Redefining Whiplash And Its Management" By The Quebec Task Force: A Critical Evaluation, presents the results of an examination of a major whiplash publication for methodologic weaknesses. The current examination of this document revealed five areas of methodologic weakness that tended to weaken or invalidate the conclusions of the authors. The fourth chapter reports the results of a case/control study of chronic neck pain and motor vehicle accident injuries. For this study, 665 individuals with chronic spine pain were queried regarding the origin of their pain. If their pain began following a MVA, they were surveyed about details of the impact. The results of the survey were used to develop\ud an exposure-odds ratio for whiplash injuries and chronic neck pain. In addition, information regarding the nature of the chronic-injury producing MVA was analyzed to\ud determine if there were any significant risk factors for chronic pain following a MVA.\ud Whiplash injuries were found to be the largest single cause of chronic spine pain in\ud population sample studies. In addition, several risk factors were found to predict\ud chronicity following an acute whiplash injury