Patients with chronic neck-pain after trauma do not differ in type of symptoms and signs, but suffer more than patients with chronic neck pain without a traumatic onset

Patients with chronic neck-pain after trauma do not differ in type of symptoms and signs, but... In this issue of the Scandinavian Journal of Pain Inge Ris and co-workers publish an interesting study comparing chronic neck pain patients whose pain condition started after a traumatic event (n = 120)– with chronic neck pain patients without an obvious traumatic event (n = 80), their hypothesis being that these two groups of patients could have differing symptoms and signs so that the traumatic neck pain patients more easily could be recognized as such [1].Patients with at least 6 months pain and at least a moderate disability (Neck Disability Index) had a thorough physical examination and they reported on several self-evaluation questionnaires covering physical and psychological symptoms. The traumatic onset neck pain patients had duration of pain of 88 months, compared with 138 months in the non-trauma-group, still the patients with a traumatic onset of neck pain had worse signs and symptoms than the non-trauma group of neck pain patients: Neck muscles performed worse, they reported poorer quality of life, more depressive symptoms, and had a worse score on the Neck Disability Index. Pressure pain thresholds were lower in the neck area.In spite of these statistically highly significant group differences, they concluded that they could not find any specific symptoms or signs in individual trauma-onset neck pain patients that were clinically different from the no-trauma-onset neck pain patients. The group differences were in degrees of symptoms, the traumatic onset neck pain patients clearly suffering more and having more severe disabilities from their neck pain.Clearly, 120 patients with chronic neck pain after trauma, in the literature and in clinical jargon also called patients with WAD – Whiplash Associated Disorders [2], or patients with NAD – Neck and Associated Disorders [1,3], did not differ in type, but in degrees, of symptoms and impairments from 80 patients with chronic neck pain without traumatic onset.Thus, their main conclusion with important implications for patients with neck pain and those trying to treat and help them is that you cannot from the symptoms-presentation and the degree of physical impairments and psychological sequelae determine that the neck pain is caused by trauma or not.Conflict of interest: None declared.References[1]Ris I, Juul-Kristensen B, Boyle E, Kongsted A, Manniche C, Søgaard K. Chronic neck pain patients with traumatic or non-traumatic onset: differences in characteristics. A cross-sectional study. Scand J pain 2017;14:1–8.10.1016/j.sjpain.2016.08.00828850421http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000391262000001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3RisIJuul-KristensenBBoyleEKongstedAMannicheCSøgaardK.Chronic neck pain patients with traumatic or non-traumatic onset: differences in characteristics. A cross-sectional studyScand J pain20171418[2]Westergren H, Freeman MD, Malmström E-M. The whiplash enigma: still searching for answers. Scand J Pain 2014;5:226–8.WestergrenHFreemanMDMalmströmE-M.The whiplash enigma: still searching for answersScand J Pain201452268[3]Côté PSH, Ameis A, Carroll L, Mior M, Nordin M, the OPTIMa Collaboration. Enabling recovery from common traffic injuries: a focus on the injured person. Ontario: Rehabilitation, U-CCftSoDPa; 2015.CôtéPSHAmeisACarrollLMiorMNordinM the OPTIMa Collaboration. Enabling recovery from common traffic injuries: a focus on the injured person Ontario Rehabilitation, U-CCftSoDPa 2015 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Scandinavian Journal of Pain de Gruyter

Patients with chronic neck-pain after trauma do not differ in type of symptoms and signs, but suffer more than patients with chronic neck pain without a traumatic onset

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Publisher
De Gruyter
Copyright
© 2016 Scandinavian Association for the Study of Pain
ISSN
1877-8860
eISSN
1877-8879
D.O.I.
10.1016/j.sjpain.2016.11.014
Publisher site
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Abstract

In this issue of the Scandinavian Journal of Pain Inge Ris and co-workers publish an interesting study comparing chronic neck pain patients whose pain condition started after a traumatic event (n = 120)– with chronic neck pain patients without an obvious traumatic event (n = 80), their hypothesis being that these two groups of patients could have differing symptoms and signs so that the traumatic neck pain patients more easily could be recognized as such [1].Patients with at least 6 months pain and at least a moderate disability (Neck Disability Index) had a thorough physical examination and they reported on several self-evaluation questionnaires covering physical and psychological symptoms. The traumatic onset neck pain patients had duration of pain of 88 months, compared with 138 months in the non-trauma-group, still the patients with a traumatic onset of neck pain had worse signs and symptoms than the non-trauma group of neck pain patients: Neck muscles performed worse, they reported poorer quality of life, more depressive symptoms, and had a worse score on the Neck Disability Index. Pressure pain thresholds were lower in the neck area.In spite of these statistically highly significant group differences, they concluded that they could not find any specific symptoms or signs in individual trauma-onset neck pain patients that were clinically different from the no-trauma-onset neck pain patients. The group differences were in degrees of symptoms, the traumatic onset neck pain patients clearly suffering more and having more severe disabilities from their neck pain.Clearly, 120 patients with chronic neck pain after trauma, in the literature and in clinical jargon also called patients with WAD – Whiplash Associated Disorders [2], or patients with NAD – Neck and Associated Disorders [1,3], did not differ in type, but in degrees, of symptoms and impairments from 80 patients with chronic neck pain without traumatic onset.Thus, their main conclusion with important implications for patients with neck pain and those trying to treat and help them is that you cannot from the symptoms-presentation and the degree of physical impairments and psychological sequelae determine that the neck pain is caused by trauma or not.Conflict of interest: None declared.References[1]Ris I, Juul-Kristensen B, Boyle E, Kongsted A, Manniche C, Søgaard K. Chronic neck pain patients with traumatic or non-traumatic onset: differences in characteristics. A cross-sectional study. Scand J pain 2017;14:1–8.10.1016/j.sjpain.2016.08.00828850421http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000391262000001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3RisIJuul-KristensenBBoyleEKongstedAMannicheCSøgaardK.Chronic neck pain patients with traumatic or non-traumatic onset: differences in characteristics. A cross-sectional studyScand J pain20171418[2]Westergren H, Freeman MD, Malmström E-M. The whiplash enigma: still searching for answers. Scand J Pain 2014;5:226–8.WestergrenHFreemanMDMalmströmE-M.The whiplash enigma: still searching for answersScand J Pain201452268[3]Côté PSH, Ameis A, Carroll L, Mior M, Nordin M, the OPTIMa Collaboration. Enabling recovery from common traffic injuries: a focus on the injured person. Ontario: Rehabilitation, U-CCftSoDPa; 2015.CôtéPSHAmeisACarrollLMiorMNordinM the OPTIMa Collaboration. Enabling recovery from common traffic injuries: a focus on the injured person Ontario Rehabilitation, U-CCftSoDPa 2015

Journal

Scandinavian Journal of Painde Gruyter

Published: Dec 29, 2017

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