Does pain extent predict ongoing pain and disability in patients with chronic whiplash-associated disorders?

Ahmed Alalawi, David W Evans, Bernard Liew, Anneli Peolsson, Nicola Heneghan, Alison Rushton, Gunnel Peterson, Marco Barbero, Deborah Falla

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This study investigates whether baseline pain extent, extracted from an electronic pain drawing, is an independent predictive factor of pain and disability measured 1 year and 2 years later in people with chronic WAD. Participants completed questionnaires assessing neck pain intensity, disability via the Neck Disability Index (NDI), psychological features, and work ability. Participants also completed electronic pain drawings from which their pain extent was extracted. A two-step modelling approach was undertaken to identify the crude and adjusted association between pain extent and NDI measured at 1-year and 2-year follow-ups. A total of 205 participants were included in the analysis. The univariate analysis showed that pain extent was significantly associated with the NDI score at the 1-year (p = 0.006, 95% CI: 0.159-0.909) and 2-year (p = 0.029, 0.057-0.914) follow-ups. These associations were not maintained when we introduced perceived disability, psychological health, and work ability into the model after 1 year (p = 0.56, 95%CI: -0.28-0.499) and 2 years (p = 0.401, -0.226-0.544). Pain extent, as an independent factor, was significantly associated with perceived pain and disability in patients with chronic WAD for up to 2 years. This association was masked by neck disability, psychological health, and work ability.

Original languageEnglish
Article number555
Number of pages11
JournalJournal of Clinical Medicine
Issue number3
Publication statusPublished - 22 Jan 2022

Bibliographical note

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.


  • Outcome
  • Pain drawings
  • Prognosis
  • Whiplash injury
  • Widespread pain

ASJC Scopus subject areas

  • Medicine(all)


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