Recovery in Whiplash-Associated Disorders: Do You Get What You Expect?

Abstract

Patients' early expectations for recovery are an important prognostic factor in recovery after whiplash injury, and are potentially modifiable. Clinicians should assess these expectations in order to identify those patients at risk of chronic whiplash, and future studies should focus on the effect of changing these early expectations.

A population‐based, incidence cohort study of mid‐back pain after traffic collisions: Factors associated with global recovery

“…These are interesting findings since they suggest that the participant's general health, including comorbid health conditions, may influence the recovery process to a greater extent than specific injury characteristics such as location‐specific pain intensity. Poor recovery expectations have previously been identified as a prognostic factor in traffic injuries (Holm et al., 2008; Carroll et al., 2009) and in non‐traumatic pain conditions such as low back pain (Kongsted et al., 2014). The experience of previous injury claims (i.e.…”

“…Neck pain intensity and self‐reported disability are two of the characteristics most consistently reported to influence the prognosis of traffic injuries (Carroll et al., 2008; Walton et al., 2013). Early post‐traumatic stress disorder symptoms and pain catastrophizing are likely also important (Walton et al., 2013), as well as depressive mood and anxiety (Phillips et al., 2010), expectations for recovery (Holm et al., 2008; Carroll et al., 2009) and pain coping strategies (Carroll et al., 2014). The wide range of prognostic factors indicates that whiplash injuries are complex in nature, involving biopsychosocial aspects of the patient and his or her life.…”

Correlation between expectations of recovery and injury severity perception in whiplash-associated disorders

“…Studies indicate that 30%-50% of whiplash patients will experience pain for at least six months after the collision, resulting in a significant impact on overall quality of life (Ferrari and Russell, 2008;Carroll et al, 2009b). Additionally, patients will consume, on average, thousands of dollars of treatment and disability benefits.…”

“…Additionally, patients will consume, on average, thousands of dollars of treatment and disability benefits. Many psychosocial factors have been associated with poor outcomes after whiplash injury, including compensation systems, expectations, and coping styles (Ferrari and Russell, 2008;Carroll et al, 2009a;2009b). Beliefs may be particularly important.…”

“…A population-based study has revealed that patients' expectations of recovery obtained during the acute stage after injury actually predict the rate of recovery (Carroll et al, 2009b). After adjusting for the effect of sociodemographic characteristics, post crash symptoms as well as pain, prior health status, and collision-related factors, those who expected to get better soon recovered over three times as quickly (hazard rate ratio=3.62, 95% confidence interval 2.55-5.13) as those who expected that they would never get better (Carroll et al, 2009b). Expectations were also predictive for returning to work after whiplash injury (Ozegovic et al, 2009).…”