Archives of Physical Medicine and Rehabilitation
Available online 4 September 2019
Jeffrey A.King DC, MS
Abstract
Objectives
To determine (1) the frequency of neck pain overall and relative to other symptoms in patients presenting to a level I trauma center emergency department (ED) with mild traumatic brain injury (mTBI) and (2) the predictors of primary neck pain in this population.
Design
Cohort study.
Setting
Level I trauma center ED.
Participants
95 patients presenting to the ED with symptoms of mTBI having been exposed to an event that could have caused a mTBI.
Interventions
Not applicable.
Main outcome measures
Frequency of self-reported neck pain as measured by Sport Concussion Assessment Tool—3 (SCAT3) symptom questionnaire at <3, 8, 15, and 45 days post-injury. Primary neck pain defined in two ways (1) neck pain rated as equal or greater in severity than all other SCAT3 symptoms and (2) neck pain worse than all other symptoms.
Results
The frequency of any reported neck pain was 68.4%, 50.6%, 49%, and 41.9% within 72 hours and at 8, 15, and 45 days, respectively. Frequency of primary neck pain (equal or worse/worse definitions) was 35.8%/17.9%, 34.9%/14.5%, 37%/14.8% and 39.2%/10.8% across the four follow-up assessments. Participants who sustained their injuries in motor vehicle crashes had a higher rate of primary neck pain than those injured due to falls.
Conclusions
A sizable percentage of patients who present to level I trauma center EDs with mTBI report neck pain, which is commonly rated as similar to or worse than other mTBI-related symptoms. Primary neck pain is more common after motor vehicle crashes than falls. These findings support consensus statements identifying cervical injury as an important potential concurrent diagnosis in patients with mTBI.