Sex-based differences in pain distribution in a cohort of patients with persistent post-traumatic neck pain

Abstract

Objectives: To analyze a cohort of 745 consecutive patients referred to a regional specialist clinic for evaluation of post-traumatic neck pain during a five-year period.

Methods: A cross-sectional observational study of baseline assessments performed by multi-professional rehabilitation teams according to a standardized checklist.

Results: The cohort contained nearly twice as many females as males (64% versus 36%). The type of injury did not differ between sexes. Of the entire cohort, 38% were diagnosed with widespread pain, 50% with regional pain, and 12% with local pain. The pain distribution among the females was 43% widespread, 48% regional, and 9% local, and corresponding figures among males were 29%, 53%, and 18%. Longer time between trauma and assessment did not affect pain distribution among the men, but a tendency towards more widespread pain was observed among the women.

Discussion: The importance of "female sex" as risk factor for the development of persistent pain after neck trauma needs to be discussed further. The high frequency of regional and widespread pain among patients with persistent neck pain after trauma calls for both multidisciplinary assessments and treatment strategies. The relationships between different pain distribution patterns, disability, activity, and psychological factors need to be studied further.

Implications for rehabilitation

• Patients suffering from pain and disability after neck trauma constitute a significant proportion of patients with persistent pain.

• The importance of the risk factor “female sex" should be further discussed in the development of persistent pain after neck trauma.

• The high frequency of regional and widespread pain among patients with persistent neck pain after trauma calls both for multidisciplinary assessments and treatment strategies.

• The relationships between different pain distribution patterns, disability, activity, and psychological factors need to be studied further.

Keywords:

• Whiplash trauma
• persistent pain
• pain distribution
• sex characteristics
• gender differences

Acknowledgements

We wish to thank registered nurse Nina Wätthammar-Ohlsson for extracting data from the patient records. The study was supported by Skane University Hospital, Lund, Sweden, and Personskadeförbundet, RTP research fund (a non-profit patient organization).

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

The study was supported by University Hospital, Lund, Sweden and The Swedish Association for Survivors of Accident and Injury (RTP-research fund), Stockholm, Sweden.