Neck Pain in Saskatchewan

An interesting study has recently been published that makes the previous article even more questionable. This new study includes, again, Dr. David Cassidy, the lead author of the Saskatchewan study�in fact, all three of the authors involved with this second paper were also authors of the no-fault study. The studies, however, seem to contradict one another.

In this second study, the researchers mailed a survey to 2,184 adults in Saskatchewan that questioned the participants about their history of neck pain; 1,131 responded to the survey. Neck pain was broken down into five categories:

Grade O — no neck pain.
Grade I — low intensity/low disability neck pain.
Grade II — high intensity/low disability neck pain.
Grade III — high disability/moderately limiting neck pain.
Grade IV — high disability/highly limiting neck pain.

Of the participants, 38.6% reported experiencing Grade I neck pain, 9% reported Grade II, and 4.8% had Grades III-IV.

Here is where the study gets interesting. According to the findings, "Almost 16% of the participants reported having previously injured their neck in a motor vehicle collision."

Furthermore, people who reported a history of neck injury from a motor vehicle collision were between 3.33 and 4.96 times as likely to suffer from neck pain as were people who had not been injured in a motor vehicle collision—a perfectly logical finding, but contrary to the previous study. The authors of the second study, however, state that the idea that neck injury from a car crash causes long-term neck pain is a "controversial hypothesis"!

The study concludes with these "Key Points:"

"Clinicians should be aware that disabling neck pain is associated with other comorbidities (headache, cardiovascular problems, digestive problems, low back pain) that negatively impact on health."
"The prevalence of neck pain and disability is higher in individuals with a lifetime history of neck injury in a motor vehicle collision."
"No associations were found between neck pain and depressive symptoms."
"Future studies on the etiology of graded neck pain and disability should consider comorbidities and trauma as possible risk factors."

Cassidy JD, Carroll LJ, Cote P, et al. Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury. New England Journal of Medicine 2000;342(16):1179.1186.
Study finds no-fault insurance a prescription for treating whiplash. CNN.com, April 12, 2000.
McNarin M. SGI accused of meddling; researcher claims she was told to falsify no-fault insurance study. The StarPhoenix, May 14, 1999.
Statement of Claim, In the Court of Queen�s Bench for Saskatchewan, Judicial Center of Saskatoon, between Dr. Emma Bartfay, plaintiff, and The University of Saskatchewan and Dr. J. David Cassidy, Defendants. Filed May 21, 1999, Q.B. #1679 of 1999.
Cote P, Cassidy JD, Carroll L. The factors associated with neck pain and its related disability in the Saskatchewan population. Spine 2000;25(9):1109-1117.

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