Pain after whiplash: a prospective controlled inception cohort study

Objectives-In Lithuania, there is little awareness of the notion that chron ic symptoms may result from rear end collisions via the so-called whiplash injury. After most such collisions no contact with the health service is es tablished. An opportunity therefore exists to study posttraumatic pain with out the confounding factors present in western societies. Methods-In a prospective, controlled inception cohort study, 210 victims of a rear end collision were consecutively identified from the daily records of the Kaunas traffic police. Neck pain and headache were evaluated by mail ed questionnaires shortly after the accident, after 2 months, and after 1 y ear. As controls, 210 sex and age matched subjects were randomly taken from the population register of the same geographical area and evaluated for th e same symptoms immediately after their identification and after 1 year. Results-Initial pain was reported by 47% of accident victims; 10% had neck pain alone, 18% had neck pain together with headache, and 19% had headache alone. The median duration of the initial neck pain was 3 days and maximal duration 17 days. The median duration of headache was 4.5 hours and the max imum duration was 20 days. After 1 year, there were no significant differen ces between the accident victims and the control group concerning frequency and intensity of these symptoms. Conclusions-In a country were there is no preconceived notion of chronic pa in arising from rear end collisions, and thus no fear of long term disabili ty, and usually no involvement of the therapeutic community, insurance comp anies, or Litigation, symptoms after an acute whiplash injury are self limi ting, brief, and do not seem to evolve to the so-called late whiplash syndr ome.