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Source: Obelieniene D, et al. Pain after whiplash: A prospective controlled inception cohort study. J Neurol Neurosurg Psychiatry 1999;66:279-283.
Whiplash injury, a condition almost always reflecting an acute neck muscle sprain, carries in most western European and North American countries a measurable risk of chronic disability characterized by neck pain, emotional disturbance, and financial litigation. In Lithuania, an impoverished Baltic country of about 3.5 million functioning under the shadow of Russia, a different response is encountered.
Schrader and colleagues, from Lithuania, reported in the Lancet (Schrader H, et al. Lancet 1996;347:1207-1211; Plum F. Neurol Alert 1996;14:92-93) the results of a historically conducted study of 202 persons with presumed whiplash recorded on police records of rear-end automobile crashes. The cohort reported no greater incidence of chronic head or neck pain when compared to a randomly identified control group. The same investigators, headed by Obelieniene, now report the results of a more recent prospective study of 210 persons involved in rear-end car accidents. They compared the injured against 210 persons randomly chosen and free of injuries. The subject groups were matched for age, gender, and a variety of education and/or employment patterns. Average collision speed of the damaging car was estimated at about 25 mph. Questionnaires were obtained on subjects following the accident on an average of 7 days, 2 months, and 1 year for all whiplash persons. Controls answered at the first and last question time. Participation was, remarkably, 94% in the injured and 92% in the controls. Ninety-eight (47%) of the injured group described either headache, neck pain, or both. Among the injured, no neck pain lasted more than 17 days (median 3 days) and no headache lasted more than 20 days (median 4.5 hours).
At the time of one year follow-up, no difference in symptoms or employment separated the accident cohort from the controls in incidence of headache, neck pain, or both. Obelieniene et al conclude, "In a country where there is no preconceived notion of chronic pain...symptoms after an acute whiplash are self-limiting (and) brief."
a. 12 months.
b. 6 months.
c. 3 months.
d. 1 month.