Whiplash recovery expectations predict recovery

A patient’s expectations for recovery from a whiplash-associated disorder (WAD), measured in the first 6 weeks after a traffic-related WAD, predict actual recovery. Pain recovery and resolution of pain-related limitations show a similar pattern.

Carroll and coworkers evaluated 6015 adults who had sustained a whiplash injury during the previous year to determine whether patients’ estimation of their recovery influenced actual outcome. Recovery was evaluated according to global self-assessment, self-rated neck pain intensity, and self-reported limitations in daily activities.

Persons who expected to improve quickly healed more than 3 times sooner than those who did not expect to return to normal. Recovery time in persons who thought they would heal slowly was intermediate-about 2.5 times faster than those who thought they would not heal. Persons who claimed to have no idea of how soon they would recover healed more slowly but still improved more rapidly than self-proclaimed nonhealers. This pattern was consistent across all 3 recovery indices.

The authors suggeisted that several psychological factors (eg, coping, depression, and anxiety) are important in recovery from a WAD and that assessing expectations for recovery is worthwhile as a means of identifying injured patients at risk for poor recovery.