• Lena W Holm, Linda J Carroll, J David Cassidy, and Anders Ahlbom.
• Institute of Environmental Medicine, Division of Epidemiology, Karolinska Institutet, Stockholm, Sweden. Lena.Holm@ki.se
• Spine. 2006 Feb 15;31(4):E98-104.

Study DesignCohort study of subjects with whiplash-associated disorders (WAD).ObjectiveTo assess the association between preinjury factors and neck pain intensity within 30 days after a motor vehicle collision.Summary Of Background DataNeck pain is the main symptom in WAD. There are studies of nonspecific musculoskeletal pain suggesting that pain intensity can be modified by psychologic, personal, or social factors, but, to our knowledge, no studies have investigated the association between such factors and neck pain intensity in WAD.MethodsThe subjects (n = 5970) either filed a claim or were treated for neck pain within 30 days after a collision. Neck pain intensity was measured on the visual analog scale.ResultsFair or poor health before the collision was associated with severe neck pain in females (odds ratio 4.0, 95% confidence interval 1.8-8.9). Other associated factors in females included low education and prior neck pain. Low family income was associated with severe neck pain in males (odds ratio 2.3, 95% confidence interval 1.5-3.4), as was prior headache and being unaware of the head position at the time of collision.ConclusionThe results suggest that neck pain intensity in WAD seems to be influenced by several factors other than characteristics related to the injury event itself.

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