A neuropathic pain component is common in acute whiplash and associated with a more complex clinical presentation

Man Ther. 2009 Apr;14(2):173-9. doi: 10.1016/j.math.2008.01.009. Epub 2008 Mar 20.

Abstract

Whiplash is a heterogeneous condition with some individuals showing features suggestive of neuropathic pain. This study investigated the presence of a neuropathic pain component in acute whiplash using the Self-reported Leeds Assessment of Neuropathic Signs and Symptoms' scale (S-LANSS) and evaluated relationships among S-LANSS responses, pain/disability, sensory characteristics (mechanical, thermal pain thresholds, and Brachial plexus provocation test (BPPT) responses) and psychological distress (General Health Questionnaire-28 (GHQ-28)). Participants were 85 people with acute whiplash (<4 weeks) (54 females, age 36.27+/-12.69 years). Thirty-four percent demonstrated a predominantly neuropathic pain component (S-LANSS>or=12). This group showed higher pain/disability, cold hyperalgesia, cervical mechanical hyperalgesia, and less elbow extension with the BPPT (p<0.03) when compared to the group with non-neuropathic pain (S-LANSS<or=12). Pressure pain thresholds (PPTs) at distant sites and psychological distress (GHQ-28) were not different between the groups (p>0.09). None of the S-LANSS items could discriminate those with cold hyperalgesia (p=0.06). A predominantly neuropathic pain component is related to a complex presentation of higher pain/disability and sensory hypersensitivity. The S-LANSS may be a useful tool and the BPPT a useful clinical test in the early assessment of whiplash.

Publication types

  • Comparative Study

MeSH terms

  • Accidents, Traffic
  • Acute Disease
  • Adult
  • Age Distribution
  • Brachial Plexus Neuropathies / diagnosis*
  • Brachial Plexus Neuropathies / epidemiology
  • Brachial Plexus Neuropathies / rehabilitation
  • Cohort Studies
  • Disability Evaluation
  • Electromyography
  • Female
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pain Measurement
  • Pain Threshold
  • Probability
  • Prognosis
  • Psychological Tests
  • Psychology
  • Quality of Life*
  • Risk Factors
  • Sensation Disorders / diagnosis*
  • Sensation Disorders / epidemiology
  • Sensation Disorders / rehabilitation
  • Sensory Thresholds
  • Sex Distribution
  • Surveys and Questionnaires
  • Whiplash Injuries / diagnosis*
  • Whiplash Injuries / epidemiology
  • Whiplash Injuries / psychology
  • Whiplash Injuries / rehabilitation
  • Young Adult