Spine
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Literature review and discussion. ⋯ Beliefs, expectations, coping, and depression all predict WAD recovery. Efforts to address these factors should take a broad-based approach. These psychological constructs should be viewed as being developed and maintained within the broader social context of family, social networks, employment, and societal processes in general. There is need for a research and clinical paradigm, which acknowledges the interrelationships between internal processes and the social context in attempts to optimize recovery and functioning in those with WAD.
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Review
Does knowledge of predictors of recovery and nonrecovery assist outcomes after whiplash injury?
Nonsystematic review. ⋯ The understanding of factors predictive of poor recovery after whiplash injury is evolving. Although more research is required to validate predictive models, some factors show consistent predictive capacity and could be used in clinical practice as potential indicators of poor recovery. It is not known if the specific targeting of modifiable prognostic indicators can be achieved or will lead to improved outcomes.
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Synthesis and application of research. ⋯ The causes of transition into chronicity after a whiplash trauma are present early and appear to be multifactorial. Pain sensitivity and psychosocial distress have recently been considered but postural deficits and the symptom of dizziness also appear to have a role.It is recommended that future research address these issues to further the understanding of the transition to chronicity after a whiplash trauma.
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Narrative review. ⋯ The fact that multiple lines of evidence, using independent techniques, consistently implicate the cervical zygapophysial joints as a site of injury and source of pain, strongly implicates injury to these joints as a common basis for chronic neck pain after whiplash.
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Merged data from two primary care prospective cohort studies. ⋯ The clinical course for LBP with self-reported referred leg pain is much worse. However, the fact that differences in outcome were not worse after adjustment suggests that baseline differences in severity and duration of back pain, demographic, and psychological characteristics largely explain the poorer outcomes in patients with referred leg pain. Future research needs to establish if similar results are observed among patients with clinically determined sciatica.