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Whiplash risk groups help predict long-term consequences

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In cases of acceleration/deceleration injury (whiplash), the possible long-term consequences can be better predicted by subdividing the injured individuals into risk groups shortly after the accident.

According to a Danish study that was presented at the recent Congress of the European Academy of Neurology in Copenhagen, Denmark, this assessment should take place within four days of the accident and take into account a variety of factors, including the type and nature of the pain, the type and number of non-painful complaints, and neck mobility.

The researchers also found that, if a patient has strong neck pain, headaches, and is in a negative emotional state, these are important indicators for judging whether the individual will be able to work again after a whiplash trauma.

The findings come from a study conducted as part of the Danish ‘Whiplash Study Group´.

Reporting on the research, the European Academy of Neurology said that chronic pain and other neurologic complaints often persist intractably many years after a car accident as consequences of a whiplash injury. Dividing injured individuals into risk groups soon after the accident can accurately predict which patients are especially in danger of suffering long-term effects from whiplash, physically as well as psychosocially.

Study author Dr M.K. Rasmussen from the University of Aarhus explained: “We developed a system years ago to divide patients into risk groups. As it now turns out, this system lets us not only predict whether or not the injured individuals will be able to work again after a year. It also allows us to estimate long-term effects.”

In the new study, a questionnaire was given to 326 individuals who had sustained a whiplash injury between 12 and 14 years earlier. This asked the patients about ongoing pain, non-painful complaints, prescribed analgesics and non-medical treatment, including a comparison with the time prior to the whiplash accident. Sick leaves were also recorded, as was a subjective assessment of the patients regarding the ramifications of the accident.

Professor Helge Kasch, lead investigator of the Danish Whiplash Study Group, said: “It turned out that more than a decade after the fact the people most heavily affected were those who had been assigned to the highest risk groups shortly after the accident.”

Specifically, these patients suffered substantially more often from neck, head, shoulder and arm pain as well as low back pain, and they exhibited various non-painful neurologic symptoms more often. They also required pain medication more frequently, and suffered to a greater extent from post-traumatic stress symptoms.

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