AUTHOR=Andersen Tonny Elmose , Ravn Sophie Lykkegaard , Carstensen Tina , Ørnbøl Eva , Frostholm Lisbeth , Kasch Helge 

TITLE=Posttraumatic Stress Symptoms and Pain Sensitization After Whiplash Injury: A Longitudinal Cohort Study With Quantitative Sensory Testing

JOURNAL=Frontiers in Pain Research

VOLUME=Volume 3 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pain-research/articles/10.3389/fpain.2022.908048

DOI=10.3389/fpain.2022.908048

ISSN=2673-561X

ABSTRACT=Posttraumatic stress symptoms (PTSS) are common after whiplash injury and associated with poor recovery. The acute stress-response may lead to pain sensitization and wide-spread pain and thereby compromise recovery. To our knowledge, no longitudinal studies have assessed the associations between early PTSS and pain sensitization over time using quantitative sensory testing (QST). The aim of the present study was to compare participants with different levels of PTSS as measured by the Impact of Event Scale (subclinical 0-8, mild 9-25, clinical  26) at baseline (<10 days post-injury) and at follow-up 1, 3, 6, and 12-month post injury on pain sensitivity, neck mobility, pain distribution and pain intensity. In total 740 participants were recruited from emergency units or general practitioners with acute neck pain after whiplash injury. The clinical PTSS group showed increased pain sensitivity on all QSTs at all time points compared to the subclinical PTSS group. Also, the clinical PTSS group showed significantly lower neck mobility at all time points except for 3-month follow-up compared to the subclinical PTSS group. Moreover, the clinical PTSS group showed more widespread pain and self-reported headache and neck pain intensity at all time points compared to the subclinical PTSS group. The present study emphasizes that participants with clinical levels of PTSS constitute a high-risk group that is sensitized to pain early after the injury. Hence, screening for PTSS within the first weeks after whiplash injury for those who experience high levels of pain intensity and distress may be an important clinical procedure in the assessment and treatment of whiplash associated disorders.