After a motor vehicle collision, roughly 80% of those who experience neck pain recover and 20% develop persistent pain and disability. There have been many studies looking at the risk factors for developing persistent neck pain and disability. Some of the findings make perfect sense while others may come as a great surprise to you.
Instead of me just telling you the risk factors, try the following true or false quiz.
The following factors predict delayed functional recovery after neck whiplash associated disorders (WAD)
(Circle either T or F and I will give you the answers at the end. Go ahead, grab a pen before continuing…do the quiz properly!)
- Impact direction……………………….T F
- Seating position……………….………T F
- Head rest position…………………….T F
- Speed of vehicle………………………T F
- Angle of the neck at time of collision T F
- Awareness of collision……………….T F
(Clue: The above 6 factors are all False! Meaning none of them predict delayed recovery. Are you surprised?)
- History of previous neck pain…………T F
- Post-traumatic distress………….…… T F
- Female……………………………..….. T F
- Less than post-secondary education…T F
- Passive coping strategies………..….. T F
- Greater initial pain intensity …………….T F
- Greater initial disability (NDI)……..…. T F
- High catastrophizing…………….……. T F
- Pre-collision depression ……………….. T F
- Pre-collision anxiety……………………… T F
- Perceived injustice ……….…….…… T F
- Poor expectations of recovery……… T F
- Generalized anxiety………………… T F
- Delayed claim settlements ………..… T F
(Clue: The above 14 factors are all True! Meaning all of them predict delayed recovery to some degree.)
The top two risk factors for delayed recovery from WAD are a previous history of neck pain and post-traumatic distress. So how can we possibly influence the above risk factors with manual therapy, soft-tissue techniques or exercises???
Reference: Ritchie C, Sterling M. Recovery Pathways and Prognosis After Whiplash Injury. J Orthop Sports Phys Ther. 2016 Oct;46(10):851-861.
Whiplash
