The association between neuropathic pain features and central sensitization with acute headache associated to a whiplash injury

Background

Headache is one of the most common symptoms after a whiplash injury, although the pathophysiology remains under discussion. This study aimed to evaluate differences in neuropathic pain and central sensitization features between those who present with whiplash-associated headache (WAH) soon after a whiplash injury and those who do not.

Methods

This case-control study evaluated differences on the self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS), Pain Detect Questionnaire (PDQ) and the Central Sensitization Inventory (CSI) between those who present with WAH in the acute phase after a whiplash injury (n = 46) and those who do not (n = 36). Moreover, the association of these variables in addition to neck pain intensity and the Neck Disability Index (NDI) score, with the presence of WAH was examined through logistic regression.

Results

While differences between groups were found for both neuropathic and central sensitization features, only the presence of neuropathic pain features was associated with the presence of headache, with 27 scores for the S-LANSS and 23 for the PDQ from 46 people with headache (58.6% and 50.0%, respectively). The NDI and the S-LANSS partially explained (R² = 0.68) the presence of WAH according to a logistic regression model.

Conclusion

Significant differences were found between people with whiplash with and without WAH when the S-LANSS, the PDQ and the CSI were assessed. S-LANSS and NDI were the variables most associated with the presence of WAH. These findings suggest that neuropathic pain features may be associated with the presence of acute WAH.