Is a lifetime history of neck injury in a traffic collision associated with prevalent neck pain, headache and depressive symptomatology?

The objective of this study is to determine whether independent associations exist between a history of neck injury related to a motor vehicle collision and: (1) graded neck pain in the past 6 months; (2) headaches in the past 6 months and; (3) depressive symptomatology during the past week. We used data from the Saskatchewan Health and Back Pain Survey, a population-based cross-sectional survey mailed to a stratified random sample of 2184 Saskatchewan adults aged 20-69 years. Fifty-five percent of the eligible population participated. The exposure was collected by asking subjects whether they had ever injured their neck in a motor vehicle collision. The outcomes: 6-month prevalence of graded neck pain, 6-month prevalence headache and depressive symptomatology during the past week were measured with valid and reliable questionnaires. Sixteen percent of the study sample reported a lifetime history of neck injury in a traffic collision. The association between neck injury and the outcomes was determined from polytomous and binary multivariate logistic regression with adjustment for age, gender and other covariates. A history of neck injury was positively associated with low intensity/low disability neck pain (OR = 2.81; 95% CI 1.81-4.37), positively associated with high intensity/low disability neck pain (OR = 4.46; 95% CI 2.49-4.99) and with disabling neck pain (OR = 3.30; 95% CI 1.48-7.39). Similarly, we found a positive association between a history of neck injury in a motor vehicle collision and headaches that moderately/severely impact on one's health (OR = 2.09; 95% CI 1.27-3.44). No association was found between neck injury and depressive symptomatology (OR = 0.84; 95% CI 0.50-1.40). Our cross-sectional analysis suggests that neck pain and severe headaches are more prevalent in individuals with a history of neck injury from a car collision. However, the results should not be used to infer a causal relationship between whiplash and chronic neck pain and headaches.