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CHAPEL HILL, North Carolina - One in four seniors who've been in a car crash will have lasting pain and many will struggle to perform basic daily activities in the months afterward, a new study suggests.
Car crashes are the second most common form of trauma among older adults, the researchers write in Annals of Emergency Medicine.
Lead author Timothy Platts-Mills of the University of North Carolina at Chapel Hill, said his team's long-term goal was to prevent this type of trauma from developing into persistent pain for older adults.
Platts-Mills said in an email: "The purpose of this study was to determine the frequency of persistent pain and functional decline and identify patient characteristics associated with these outcomes."
His team recruited 161 patients aged 65 and older who went to an emergency ward after a car crash but didn't stay in hospital. Patients with fractures, major cuts, and brain or spine injuries were not included in the analysis.
The participants were interviewed in person at the hospital. They also completed follow-up assessments by mail or phone at six weeks, six months, and a year after the accident.
PAIN RATING
According to the study, pain was rated on a scale from 1 to 10, both overall and in 15 specific parts of the body. People reporting a pain level of four or higher after six months were considered to have persistent pain.
Participants also rated their ability to perform daily functions such as walking, climbing stairs, and carrying groceries.
In the initial emergency-ward interview, 72% of patients reported moderate to severe pain. After six months 26% were still having moderate to severe pain. People with persistent pain were more likely to have had pain in the head, neck, jaw, lower back, or legs in the emergency ward.
Compared to patients without pain, patients who did have chronic pain reported poor self-rated health and less formal education. They were also more likely to have symptoms of depression before the crash and to expect their recovery to take more than 30 days.
HEALTH PROBLEMS
Participants with persistent pain also experienced much more "pain interference" with their physical functioning and daily living activity and were more likely to have changed their living situation to get extra help.
Roger Fillingim, a distinguished professor at the University of Florida College of Dentistry, noted that chronic pain was very common and affected 100-million people in the United States.
Fillingim, who studies the problem, said in an email that chronic pain is "arguably the most expensive and most prevalent health problem in the United States" and that this was particularly true for older adults.
Persistent pain carries additional health and safety risks. Previous studies have shown that it increases risk of falls and may be associated with decreased cognitive performance in older people, Fillingim noted.
TAKE EARLY CONTROL
Platts-Mills said one way to combat persistent pain was to tackle it early. "More effective control of pain symptoms in the emergency department and in the early recovery period may reduce persistent pain," he said.
For older people who have been in a crash, Platts-Mills recommends staying physically active to reduce long-term pain and decline in physical functioning. He also noted that many of the study's participants had not been re-evaluated by a physician after a few weeks, and that that may be part of the issue.
"If you or a family or friend is in a car crash, it is important to be re-evaluated if pain symptoms persist."
SOURCE: bit.ly/1SQKq4g Annals of Emergency Medicine, online June 16, 2015.
