Psychological traumas intensify whiplash
Injuries from traffic accidents are compounded by posttraumatic stress disorder. Pain rehabilitation should start by treating psychological trauma, new study suggests.
Whiplash is a common consequence of car accidents, and many of these victims also develop posttraumatic stress disorder (PTSD).
According to a new study, PTSD can aggravate the damage from the whiplash and further increase the pain.
”We have found that PTSD leads to an increased bodily awareness and a fear of movement,” says psychologist Tonny Elmose Andersen, of the Department of Psychology at the University of Southern Denmark.
“This is why PTSD patients tend to feel stronger pain than they otherwise would.”
PTSD starts a chain reaction
We have found that PTSD leads to an increased bodily awareness and a fear of movement. This is why PTSD patients tend to feel stronger pain than they would otherwise.
Tonny Elmose Andersen
The study indicates that the development of PTSD after an accident can create an unwanted chain reaction:
1. PTSD contributes to an increase in negative thoughts about the physical pain after an accident.
2. The negative thoughts – also known as catastrophic thinking – make the patients reluctant to move for fear of making the injury even worse.
3. When patients don’t move, they often experience muscle tension, which contributes to intensifying the injury.
“The conclusion is that PTSD contributes to a significant share of patients developing persistent pain after a whiplash,” says the researcher.
Great differences in pain cycles
Andersen has examined all whiplash cases at Aarhus Hospital’s emergency room from 2009 to 2011. He subsequently followed patients for at least six months after their accidents.
The survey revealed that patients with moderate to severe pain six months after the whiplash injury showed significant symptoms of PTSD within the first month after the accident. Thirty percent of these patients fulfilled the criteria for a PTSD diagnosis six months after the accident.
On the other hand, only three percent of patients who experienced mild pain showed symptoms of PTSD.
Pain should be treated psychologically
Based on these findings, the researcher suggests that whiplash rehabilitation should start with treatment of the psychological trauma if the injuries occurred in for instance a car accident.
In Canada, psychologists have obtained promising results by reducing the physical pain with the use of preventive psychological treatment as early as 12 weeks after the accident that caused the whiplash.
“Early treatment of anxiety and catastrophic thinking in particular has proved effective because this prevents people from ruminating about their pain,” he explains.
Chronic pain should be treated at an earlier stage
The study also showed that whiplash patients rarely improve their condition unless the improvements occur in the first three months following the injury.
“I could see that chronic pain kicked in after only three months,” he says.
“Today, chronic pain is usually not treated until several years after it emerged. But if the pains are chronic after only three months, it is advantageous to start the treatment before they take root, so to speak. This also applies to pain management through treatment of PTSD.”
Read this story in Danish at videnskab.dk
Translated by: Dann Vinther
- The traumatised chronic pain patient—Prevalence of posttraumatic stress disorder - PTSD and pain sensitisation in two Scandinavian samples referred for pain rehabilitation, Scandinavian Journal of Pain; doi: 10.1016/j.sjpain.2011.10.001