A Population-based, Incidence Cohort Study of Mid-back Pain After Traffic Collisions
Written by Editor   
Thursday, January 19, 2017 10:39 AM

News Bite:  This study explores Mid-back pain as a result of traffic-related injury.  About 50 to 80% of individuals involved with these injuries experience Whiplash-Associated Disorders (WAD).  Mid-back pain is one of these symptoms.  In this study the median time-to-first reported recovery was 101 days and about 23% were still not recovered after 1 year.  About half of those with WAD report neck symptoms 1 year after the injury, indicating a prolonged recovery in a substantial proportion of these patients.

 


The most common traffic-related injury, affecting about 50–80% of all injured individuals, is the whiplash injury.  Individuals experiencing this type of injury often report a variety of clinical manifestations, described as Whiplash-Associated Disorders (WAD). Mid-back pain (MBP) is one of these symptoms. 

The annual cumulative incidence of WAD is likely to be between 300 and 600 per 100,000 inhabitants in North America and Western Europe. The incidence and prognosis of different traffic injuries and their related conditions (e.g. neck pain, low back pain, depression or others) has been investigated previously; however, knowledge about traffic collision-related MBP is lacking. This study's objectives were to describe the incidence, course of recovery and prognosis of MBP after traffic collisions, in terms of global self-reported recovery.

Longitudinal data from a population-based inception cohort of all traffic injuries occurring in Saskatchewan, Canada, during a 2-year period were used. Annual overall and age-sex-specific incidence rates were calculated, the course of recovery was described using the Kaplan-Meier technique, and associations between participant characteristics and time-to-self-reported recovery were explored in 3,496 MBP cases using Cox proportional hazards models.

The yearly incidence rate was 236 per 100,000 population during the study period, and was highest in women and in young persons. The median time-to-first reported recovery was 101 days and about 23% were still not recovered after 1 year. Participant’s expectation for recovery, general health, extent of severely affecting comorbidities and having experienced a previous traffic injury were some of the prognostic factors identified.

About half of those with WAD report neck symptoms 1 year after the injury, indicating a prolonged recovery in a substantial proportion of these patients. Neck pain intensity and self-reported disability are two of the characteristics most consistently reported to influence the prognosis of traffic injuries. Early post-traumatic stress disorder symptoms and pain catastrophizing are likely also important, as well as depressive mood and anxiety, expectations for recovery and pain coping strategies. 

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.


Source:  http://chiro.org/wordpress/2016/12/a-population-based-incidence-cohort-study-of-mid-back-pain-after-traffic-collisions/