Coping Strategies and Whiplash

Coping strategies in chronic pain patients have been found as a major predictor of physical and psychological outcomes. If a patient possesses healthy coping mechanisms, they can handle stressors more effectively, experience fewer symptoms, recover faster, and require less rehabilitation. This current study compared 40 patients suffering after whiplash trauma to 33 patients with unrelated-whiplash muskoskeletal pain. With an emphasis placed on evaluating life satisfaction and coping strategies, they studied the effects of a multi-disciplinary rehabilitation program. The program's aim was to get whiplash patients back to work, offering support in formulating realistic goals, and guiding their physical exercises.

The researchers used the Coping Resources Inventory, which assesses coping capabilities in five major areas: cognitive, social, emotional, philosophical, and physical. At the baseline evaluation, whiplash patients had a mean score of 153 as compared to the control group's 162. After the rehabilitation program, 32 patients (49%) had improved their total coping abilities. The authors explain the increase:

"The main increase in coping resources under the six-week period seemed to be due to an increase in physical coping resources. Thus, it is possible that the attitude changes accomplished during treatment further facilitated a reduction of pain problems, possibly by motivating the person to continue use of the acquired strategies."

The scores for life satisfaction followed the same trend. Whiplash patients scored poorly at the beginning of the study, yet, after rehabilitation, 30 patients (45%) increased their scores. These two elements simply indicate that a high rate of both coping resources and life satisfaction will lend itself to a high return to work. Predictors of non-return to work emerged in the study, such as low life satisfaction and no increase in resources during or after rehabilitation. So, the authors conclude that evaluating coping resources and life satisfaction is a "useful tool for evaluating both treatment progress and potential long-term coping among chronic pain patients."

Heikkila H, Heikkila E, Eisemann M. Predictive factors for the outcome of a multidisciplinary pain rehabilitation programme on sick-leave and life satisfaction in patients with whiplash trauma and other myofascial pain: a follow up study. Clinical Rehabilitation 1998;12:487-496.