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Gennis P; Miller L; Gallagher EJ; Giglio J; Carter W; Nathanson N

Bronx Municipal Hospital Center, Department of Emergency Medicine, NY 10461, USA. pskm34a@prodigy.com

Acad Emerg Med 1996 Jun;3(6):568-73

PMID: 8727627 UI: 96326746

Comment in: Acad Emerg Med 1996 Jun;3(6):563-4

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.

*Braces
Neck Pain/*etiology
Whiplash Injuries/*rehabilitation

Adult
Analgesics/therapeutic use
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
Combined Modality Therapy
Comparative Study
Female
Human
Male
Pain Measurement
Treatment Outcome

CLINICAL TRIAL
JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL

0 (Analgesics)
0 (Anti-Inflammatory Agents, Non-Steroidal)

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