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. 2013 Sep;17(8):1243-51.
doi: 10.1002/j.1532-2149.2013.00285.x. Epub 2013 Jan 20.

Pain distribution and predictors of widespread pain in the immediate aftermath of motor vehicle collision

A V Bortsov  1 , T F Platts-Mills, D A Peak, J S Jones, R A Swor, R M Domeier, D C Lee, N K Rathlev, P L Hendry, R B Fillingim, S A McLean
Affiliations

Pain distribution and predictors of widespread pain in the immediate aftermath of motor vehicle collision

A V Bortsov et al. Eur J Pain. 2013 Sep.

Abstract

Background: Musculoskeletal pain is common after motor vehicle collision (MVC). The study objective was to evaluate distribution of pain and predictors of widespread musculoskeletal pain in the early aftermath (within 48 h) of collision.

Methods: European American adults aged 18-65 years presenting to the emergency department (ED) after collision who were discharged to home after evaluation were eligible. Evaluation included an assessment of reported pre-collision psychological characteristics, crash characteristics, current pain severity and location, and current psychological symptoms. Adjusted risk ratios were estimated using generalized linear models.

Results: Among 890 participants included in the study, 589/890 (66%) had pain in three or more regions, and 192/890 (22%) had widespread musculoskeletal pain (pain in seven or more regions). In adjusted analyses, the presence of widespread pain was strongly associated with depressive and somatic symptoms prior to collision, pain catastrophizing, and acute psychological symptoms, and was not associated with most collision characteristics (road speed limit, extent of vehicle damage, collision type, driver vs. passenger, airbag deployment). The reported number of body regions that struck an object during the collision was associated with both reported pre-collision depressive symptoms and with widespread pain.

Conclusion: More than one in five individuals presenting to the ED in the hours after MVC have widespread pain. Widespread pain is strongly associated with patient characteristics known to be modulated by supraspinal mechanisms, suggesting that stress-induced hyperalgesia may influence acute widespread pain after collision.

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Figures

Figure 1
Figure 1. Study recruitment flowchart
Patients may have multiple reasons for ineligibility or refusal. ED, Emergency Department; EA, European American; MVC, motor vehicle collision.
Figure 2
Figure 2
Percentage of participants and overall pain scores (mean ± standard error) by number of pain sites in the immediate aftermath of motor vehicle collision. Number of pain sites and overall pain score were significantly associated (Pearson r = 0.38, p < 0.001).
Figure 3
Figure 3
Percentage of participants reporting pain in the early aftermath of motor vehicle collision according to body region (pain score > 0, 0–10 scale).
See this image and copyright information in PMC

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