“Passive” coping may slow whiplash recovery

In brief

  • People who used passive coping strategies six weeks after a whiplash injury had a slower recovery.
  • It is important for clinicians to assess coping strategies early in whiplash patients.

Why was this study done?

People cope with whiplash injuries in one of two ways – by actively controlling their pain and continuing to function, or by passively withdrawing from activities and using medication to control pain. Researchers are starting to study how pain-coping strategies are linked to recovery from soft-tissue injuries. This study looked at this link in patients with whiplash, which is a type of soft-tissue or musculoskeletal injury.

How was the study done?

The study drew from a population of more than 2,200 people in the province of Saskatchewan. Participants had made an insurance claim for a traffic-related whiplash injury between December 1997 and November 1999. Their insurance application form had information on their injury-related pain and symptoms and other relevant information. After providing consent, participants were interviewed by telephone five times: six weeks, and three, six, nine and 12 months after the injury.

What did the researchers find?

Passive coping strategies – identified six weeks after the whiplash injury – predicted a slower recovery. Passive coping referred to restricting social activities due to pain, wishing for better pain medications or focusing on the pain with thoughts such as, “This pain is wearing me down.” For those who also had symptoms of depression, passive coping had a particularly strong effect in slowing recovery.

What are some strengths and weaknesses of the study?

One strength was that the study had many participants from the general population and few were lost in follow-up interviews. The researchers also used a brief but well-validated survey instrument to measure coping styles. However, the instrument asks about coping strategies for moderate or greater levels of pain, so the findings may not apply to those with mild pain.

Publication Information

Title: 

Author(s): 

Carroll L, Cassidy D, Côté P

Journal: 

Pain, 2007: vol. 124, nos. 1-2, pp. 18-26