The Influence of "Labels" for Neck Pain on Recovery Expectations Following a Motor Vehicle Crash: An Online-Randomized Vignette-Based Experiment.

Abstract

<b>OBJECTIVES:</b> To (1) investigate whether different labels for neck pain after a motor vehicle crash (MVC) influenced recovery expectations and management beliefs, (2) explore reasons for low recovery expectations and greater likelihood for lodging a claim, and (3) explore the moderating effect of neck pain history and sociodemographic characteristics. <b>DESIGN:</b> Online randomized experiment with nested qualitative content analysis. <b>METHODS:</b> We randomized 2229 participants from the general population (mean age: 46.7 ± 17.5 years; 72.4% females; 66% with previous or current neck pain; 10% with an MVC experience) to read 1 of 5 scenarios describing a patient with neck pain after an MVC, each was labeled as <i>whiplash injury</i>, <i>whiplash-associated disorder</i>, <i>posttraumatic neck pain</i>, <i>neck pain</i>, or <i>neck strain.</i> The primary outcome was recovery expectations, rated on a 0- to 10-point scale. <b>RESULTS:</b> Participants allocated to <i>whiplash-associated disorder</i> or <i>neck pain</i> had lower recovery expectations than those allocated to <i>neck strain</i> (adjusted mean difference [95% confidence interval]: -0.5 [-0.9 to -0.1] for both comparisons). <i>Whiplash-associated disorder</i> led to more recovery uncertainty, while <i>neck pain</i> led to greater doubt about the health care provider. Most secondary outcomes showed significant but small differences. Participants allocated to <i>neck strain</i> were less inclined to claim than those allocated to <i>whiplash-associated disorder</i> or <i>whiplash injury</i> due to less perceived need for financial support. Neck pain history moderated labeling effects on recovery expectations; household income moderated the claim intention. <b>CONCLUSIONS:</b> Labels for neck pain after an MVC influenced recovery expectations and management preferences. The clinical relevance of the small effects was unclear. <i>J Orthop Sports Phys Ther 2024;54(11):1-10. Epub 5 September 2024. doi:10.2519/jospt.2024.12590</i>.