Higher Neck Pain Intensity and the Presence of Psychosocial Factors Are More Likely When Headache is Present after a Whiplash Injury: A Case-Control Study

Abstract

Background Several factors such as neck pain intensity, disability, anxiety, depression, female sex, or a previous history of headache are associated with post-whiplash headache. However, the possible role of psychosocial factors contributing to the presence of headache or worsening of headache after a whiplash trauma remains unclear. To address this gap in knowledge, there is the need to assess psychosocial factors concerning headache shortly after a whiplash injury.

Objective To evaluate psychological features, pain and disability in people with acute whiplash associated disorders (WAD) and compare these features between those with and without headache.

Design Case-control study.

Setting A secondary care traumatology center.

Methods Forty-seven people with acute WAD were recruited; 28 with headache, and 19 without. All participants completed self-reported questionnaires including Visual Analogue Scale (VAS) for neck pain intensity, the Neck Disability Index (NDI), Pain Catastrophizing Scale (PCS), Tampa Scale Kinesiophobia-11 (TSK-11), and State-Trait Anxiety Inventory.

Results Neck pain intensity (P < .001), neck disability (P < 0.001), pain catastrophizing (P < .001), kinesiophobia (P < .001), and anxiety state (P = .007) and trait (P = .05) were higher in those with headache when compared to those without. In addition, high levels of neck pain (P = .025), moderate levels of neck disability (P < .001), moderate levels of pain catastrophizing (P = .015), and moderate (P = .002) and severe (P = .016) levels of kinesiophobia were related to the presence of headache.

Conclusions The level of neck pain intensity and disability, kinesiophobia, catastrophizing, and anxiety were all greater in people with acute WAD who presented with a headache compared to those without headache.