The effect of soft cervical collars on persistent neck pain in patients with whiplash injury.

Abstract

OBJECTIVE:

To assess the efficacy of soft cervical collars in the early management of whiplash-injury-related pain.

METHODS:

A controlled, clinical trial was conducted in an urban ED. Adults with neck pain following automobile crashes indicated their initial degrees of pain on a visual analog scale. Patients with cervical spine fractures or subluxation, focal neurologic deficits, or other major distracting injuries were excluded. Patients were assigned to receive a soft cervical collar or no collar based on their medical record numbers. Pain at > or = 6 weeks postinjury was coded as none, better, same, or worse, and analyzed as 3 dichotomous outcomes: recovered (pain = none); improved (pain = none or better); and deteriorated (pain = worse).

RESULTS:

Of 250 patients enrolled, 196 (78%) were available for follow-up. Of these patients, 104 (53%) were assigned to the soft cervical collar group, and 92 (47%) to the control group. These groups were similar in age, gender, seat position in the car, seat belt use, and initial pain score. Pain persisted at > or = 6 weeks in 122 (62%) patients. The groups showed no difference in follow-up pain category (p = 0.59). There was no significant difference between the 2 groups in complete recovery (p = 0.34), improvement (p = 0.34), or deterioration (p = 0.60). The study had a power of 80% to detect an absolute difference of at least 20% in recovery, 17% in improvement, and 7% in deterioration (2-tailed, alpha = 0.05).

CONCLUSIONS:

Most patients with whiplash injuries have persistent pain for at least 6 weeks. Soft cervical collars do not influence the duration or degree of persistent pain.

• Authors: P Gennis, L Miller, E J Gallagher, J Giglio, W Carter, N Nathanson
• Journal: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine (Acad Emerg Med) Vol. 3 Issue 6 Pg. 568-73 (Jun 1996) ISSN: 1069-6563 [Print] United States
• PMID: 8727627 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Analgesics
• Anti-Inflammatory Agents, Non-Steroidal

Topics

• Adult
• Analgesics (therapeutic use)
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Braces
• Combined Modality Therapy
• Female
• Humans
• Male
• Neck Pain (etiology)
• Pain Measurement
• Treatment Outcome
• Whiplash Injuries (rehabilitation)