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Medicineworld.org: Aggressive treatment for whiplash no benefit

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Aggressive treatment for whiplash no benefit

Aggressive treatment for whiplash no benefit
Whiplash, the most common traffic injury, leads to neck pain, headache and other symptoms, resulting in a significant burden of disability and health care utilization. Eventhough there are few effective therapys for whiplash, a growing body of evidence suggests that the type and intensity of therapy received shortly after the injury have a long-lasting influence on the prognosis. A new study reported in the June 2007 issue of Arthritis Care & Research (http://www.interscience.wiley.com/journal/arthritiscare) examined whether the association between early types of care and recovery time shown in an earlier study was reproducible with whiplash compensated under tort insurance.

A prior study led by Pierre Ct, of the University of Toronto in Toronto, Canada, observed that patients compensated under no-fault insurance had a longer recovery if they visited general practitioners numerous times and/or consulted chiropractors or specialists than if they just visited general practitioners once or twice. In the current study, the authors examined patterns of care for 1,693 patients with whiplash injuries who were compensated under tort insurance.

The results showed that increasing the intensity of care to more than 2 visits to a general practitioner, 6 visits to a chiropractor, or adding chiropractic care to general practitioner care was linked to slower recovery. "The results agree with our prior analysis in a cohort of patients compensated under a no-fault insurance scheme and support the hypothesis that the prognosis of whiplash injuries is influenced by the type and intensity of care received within the first month after injury," the authors state.

They note that effective care, if medically needed, improves the prognosis of patients and that practice guidelines recommend therapy shortly after the injury. However, it may be that doctors responding to pressure from patients use therapys, schedule follow-up visits and refer patients to specialists when not medically needed. "This in turn may lead to adverse outcomes and even prolong recovery by legitimizing patients fears and creating unnecessary anxiety," as per the authors. It is also possible that early aggressive therapy delays recovery by encouraging the use of passive coping strategies. "Reliance on frequent clinical care, a form of passive coping strategy, may have a negative effect on recovery by reinforcing the patients belief that whiplash injuries often lead to disability," the authors state. They cite another study that showed that whiplash patients who used coping strategies such as wishing for pain medicine or believing that they couldnt do anything to lessen the pain had a slower recover than those who did not use such strategies.

Unlike the prior study, the current one did not show a slower recovery for patients who consulted a general practitioner and a specialist. This suggests that the insurance system (tort versus no-fault) can affect the association between certain patterns of care and recovery because it may influence how patients perceive their medical needs, the pressure they put on clinicians to be referred, and how insurers require them to legitimize their injury. The authors conclude that further trials "are essential to understand the influence of health care provision in preventing or facilitating disability".


Posted by: Mark    Source




Did you know?
Whiplash, the most common traffic injury, leads to neck pain, headache and other symptoms, resulting in a significant burden of disability and health care utilization. Eventhough there are few effective therapys for whiplash, a growing body of evidence suggests that the type and intensity of therapy received shortly after the injury have a long-lasting influence on the prognosis. A new study reported in the June 2007 issue of Arthritis Care and Research (http://www.interscience.wiley.com/journal/arthritiscare) examined whether the association between early types of care and recovery time shown in an earlier study was reproducible with whiplash compensated under tort insurance.

Medicineworld.org: Aggressive treatment for whiplash no benefit

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