Factors influencing recovery from headache after common whiplash

Abstract

Objective: To assess the relation between pretraumatic and trauma related headache in patients suffering from whiplash. Design - Follow up study of patients examined a mean (SD) of 7.4 (4.2) days after treatment and again at three and six months. Setting - Patients referred from primary care. Subjects - 117 patients (mean age 30.8 (9.5) years. Main outcome measures - Prevalence of trauma related headache and the predictive relation by multiple logistic regression between different somatic and psychological variables and trauma related headache at each examination. Results - Prevalence of trauma related headache decreased from 57% to 27%. History of pretraumatic headache proved a significant risk factor for presenting with trauma related headache. A significant relation between trauma related headache and the following variables was found: at seven days the initial wellbeing score, early onset of neck pain, depression scale from the personality inventory, and the initial intensity of neck pain; at three months, intensity of neck pain, and history of pretraumatic headache; and at six months neck pain, pain intensity, and history of pretraumatic headache. Conclusions - History of pretraumatic headache significantly increases the likelihood of presenting with trauma related headache but only in combination with findings indicative of clinically important injury to the cervical spine.