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Preventing Chronic Whiplash Pain

First received on July 16, 2001. Last updated on August 9, 2013.

Purpose

This study is aimed at developing ways to prevent acute pain from becoming chronic pain--specifically, painassociated with whiplash-associated disorders (WADs) from motor vehicle accidents. Research on thedevelopment of chronic pain due to musculoskeletal injury suggests that a person's initial emotional reactions,particularly fear of reinjury and subsequent avoidance of activity, contribute significantly to chronic pain andpersistent disability. This study will treat people with WADs during the first three months after a motor vehicleaccident with a behavioral and physical exercise program designed to encourage activity and discouragecontinued fear of movement, pain, and disability. The study will compare the effectiveness of two anxiety-reduction treatments to standard care in reducing pain and activity limitations in people with WADs in the 2 to3 months after motor vehicle accidents.

Status Completed

Conditions Whiplash Injuries

Phase Phase 3

StudyType

Interventional

StudyDesign

Allocation: Randomized, Endpoint Classification: Safety Study, InterventionModel: Single Group Assignment, Masking: Single Blind, Primary Purpose:Prevention

OfficialTitle

Preventing Chronic Whiplash Pain: Biobehavioral Approach

Further study details (as provided by National Institutes of Health Clinical Center (CC))

Enrollment 300

Study Start Date May 2001

Detailed Description

More than 1.8 million people in the United States suffer from chronic pain and disability following motor vehicleaccidents (MVAs) each year. The majority of these cases start with a relatively minor neck injury. The QuebecTask Force Study on Whiplash Associated Disorders (WAD) was created in 1989 to determine the clinical,public health, social, and financial determinants of WAD. Multiple studies have described the clinical featuresof WAD, which include neck, shoulder, arm, low back, and head pain; tinnitus; visual symptoms; dizziness;temporomandibular joint pain; and paraesthesias. Onset of these symptoms after the injury is usually delayedfor several hours and worsens within 24 to 48 hours. Neck pain is the most frequent symptom, and between14% and 42% of patients with WAD develop chronic neck pain symptoms. Studies suggest that the neck painwill either resolve in the first few months or persist indefinitely. One variable that may predict outcome after anMVA is the acute emotional response immediately after the MVA. A severe emotional reaction accompaniedby neck pain and stiffness after an MVA could lead an injured person to avoid subsequent physical activitythrough such mechanisms as fear avoidance and fear of reinjury. Research investigating the evolution ofchronic pain due to musculoskeletal injury suggests that initial emotional reactivity, particularly fear of reinjuryand subsequent activity avoidance, contributes significantly to unremitting pain and persistent disability.Research based on this model has shown that early interventions targeting normalization of excessiveemotionality and restriction of activities associated with fear following injury effectively prevent chronic pain dueto back injury. No previous study has sought to intervene during the first three months after an MVA with abehavioral and physical exercise program to encourage activity and discourage continued fear of movement,pain and disability. This study consists of two primary components: (1) To compare the effectiveness of twoanxiety-reduction treatments with standard care in reducing pain and activity limitations in patients with WADs2 to 3 months following MVAs. (2) To test whether psychological responses to the initial trauma, such as fear

4/8/2014 Preventing Chronic Whiplash Pain: Biobehavioral Approach

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avoidance, fear of injury, and negative affectivity, discriminate between symptomatic WAD patients and WADsufferers whose symptoms had resolved 2 to 3 months post-MVA.

Eligibility

Minimum Age Eligible for Study: 20 Years

Maximum Age Eligible for Study: 65 Years

Genders Eligible for Study: Both

Criteria

Inclusion Criteria: - Have whiplash injury following a motor vehicle accident in the prior 4 to 10 weeks

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00021476

Contacts

Locations

University of Washington

Status:

Facility: Seattle, Washington, United States 98195-6540

Sponsors and Collaborators

University of Washington

More Information

Click here for the WADS Web site.

Other Publications

First Received: July 16, 2001

Last Updated: August 9, 2013

ClinicalTrials.gov Identifier: NCT00021476

Health Authority: United States: Federal Government

ClinicalTrials.gov processed this data on August 14, 2013 Link to the current ClinicalTrials.gov record.