A prospective study of acceleration-extension injuries following rear-end motor vehicle collisions

Objectives: To describe pain syndromes among individuals involved in rear-end motor vehicle collisions [MVCs] for up to two years post-injury. To describe rear-end MVCs by: characteristics of individuals, vehicles, and circumstances surrounding collisions. Methods: Between 1 October 1995 and 31 March 1998, 446 adults involved in rear-end MVCs presented to the emergency departments serving Kingston, Ontario, Canada. Eligible subjects [N = 380] were contacted by telephone following the collisions then at 1, 2, 3, 6, 9, 12, 18 and 24 months post-MVC. Data were collected regarding: symptoms, treatments, work and leisure activities, the collision, and compensation sought and/or received. Results: Ninety-three percent of eligible subjects participated in the study. Sixty-one percent experienced whiplash associated disorder [WAD] [with neck pain] of important severity and frequency following the collision. This declined to 37%, 35%, 34% and 36% at 3, 6, 12 and 24 months post-injury. Common associated symptoms accompanying WAD at six months included: low back pain [44%], neck stiffness [44%], headaches [43%], upper extremity numbness/weakness [26%], and visual complaints [14%]. Sixty percent missed less than one week of work after the collision. At six months, 36% continued to modify their work activities and 35% their leisure activities. Many of the collisions [46%] occurred at an intersection with the majority of vehicles [77%] stopped when hit from behind. The majority of the sample was female [65%] mean age 37 years. Few persons [7.7%] sought financial compensation, and none received any for pain and suffering. Conclusions: This study provides new data about factors associated with WAD following rear-end collisions. Substantial proportions were affected for up to two years post-injury. Repercussions of WAD are reflected in the actual number of individuals with persistent pain, and in the complex array of associated symptoms, treatments sought, and impact on work and leisure activities. These findings exist in an environment where compensation is infrequent.