Onset of Neck Pain After a Motor Vehicle Accident: A Case-Control Study

ABSTRACT. Objective. To assess the relative contribution of constitutional (individual) factors, pre-accident health, psychological and workplace psychosocial factors, and accident related (mechanical) factors in the development of neck pain (whiplash) following a motor vehicle accident. Methods. We conducted a case-control study of drivers (ages 17-70 yrs) who reported a motor vehicle accident to their insurance company. A self-report mailed questionnaire retrospectively collected information on the driver's pre-and post-accident health, details of the accident, and other exposure data. Case/control status (post-accident neck pain) was ascertained using a preshaded manikin. Results. In total, 26% of drivers reported post-accident neck pain. Women, younger individuals, and those with a history of neck pain were more likely to report neck pain following their accident (OR New episodes of neck pain are very frequent in the general population, and a number of population based studies have investigated risk factors for its occurrence. A combination of constitutional (individual) and psychological factors have been shown to predict a new episode of neck pain 1 . The importance of psychological 2 , psychosocial 3 , and mechanical factors 3,4 has been confirmed by others. In the UK, it has been estimated that roughly 250,000 cases of whiplash result from motor vehicle accidents each year 5 . Neck pain is the cardinal feature of this common problem. While the body of evidence on prognosis for individuals suffering whiplash has been growing in recent years, there remains a dearth of information about the factors associated with the onset of neck pain following such accidents. Studies examining the etiology of neck pain following vehicle trauma have suggested that female sex 6-9 , rear-end collision 9,10 , and a history of neck pain 7 are important risk factors. Age has also been implicated, although results are conflicting; some suggest that older age is a risk factor 6 , while others report an increased risk among younger individuals MATERIALS AND METHODS A case-control study design was adopted based on the recruitment of individuals reporting an accident to a national insurance company in the UK. Recruitment. At the time of the initial post-accident telephone contact with the insurance company, consecutive driver-policyholders (ages 17-70 yrs) were asked for their consent for study participation. Recruitment commenced March 1, 2002, and continued for a 14 month period. Anonymized details (age, sex, and whether the driver was at fault for causing the acciPersonal non-commercial use only. The Journal of Rheumatolog