Acute Neck Pain Predicts Post-Injury Complications After Traumatic Brain Injury
Mild traumatic brain injury (TBI), also called concussion, is one of the most common reasons for emergency department visits in the United States. Although mild TBI is not typically life-threatening, this injury is associated with a number of poor health outcomes in the recovery period, including fatigue, headache, irritability, sleep problems, and trouble concentrating. Most people fully recover from mild TBI within a few weeks of injury, but some will experience persistent symptoms for months or years. Because long-term concussion symptoms can significantly interfere with a person’s quality of life, clinicians are motivated to identify patients who are high-risk for persistent symptoms and refer them to additional recovery supports and services.
Recently, a research team in the Netherlands found that neck pain is a strong predictor of persistent symptoms after mild TBI. Researchers studied 922 participants who were admitted to the emergency department for mild TBI, 156 of whom reported acute neck pain as one of their symptoms. Compared to patients who did not report neck pain, those with neck pain were more likely to be young, female, and injured during a motor vehicle accident. They were also less likely to make a full recovery from their TBI, and were more likely to have persistent concussion symptoms at six months after the initial injury.
The researchers suggest that clinicians can use neck pain to identify patients who are at risk for incomplete recovery after mild TBI. Currently, the standard treatment for persistent post-concussion symptoms is psychoeducation about TBI and methods for healthy living, pain management, and physical activity recommendations. Patients who report acute neck pain after mild TBI may benefit from earlier psychoeducational interventions and may require early therapeutic treatment targeted specifically for the spine. Further research is necessary to determine the best treatment options for reducing and managing persistent post-concussive symptoms among individuals who report neck pain after TBI.
Coffeng SM, Jacobs B, Koning ME, et al. Patients with mild traumatic brain injury and acute neck pain at the emergency department are a distinct category within the mTBI spectrum: A prospective multicentre cohort study. BMC Neurology. (August 2020).