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Review paper

Clinical efficacy of diazepam after whiplash: a randomized controlled study

By
Edin Mešanović Orcid logo ,
Edin Mešanović
Contact Edin Mešanović

Orthopaedic Surgery and Traumatology Department, Cantonal Hospital “Dr. Safet Mujic”, Mostar, Bosnia and Herzegovina

Ćamil Habul ,
Ćamil Habul

Orthopaedic Surgery and Traumatology Department, Cantonal Hospital “Dr. Safet Mujic”, Mostar, Bosnia and Herzegovina

Ermin Hadžić
Ermin Hadžić

Orthopaedic Surgery and Traumatology Department, Cantonal Hospital “Dr. Safet Mujic”, Mostar, Bosnia and Herzegovina

Abstract

Aim
To investigate the role of short-term diazepam therapy for improving long-term outcomes and reducing neck pain after whiplash injury.
Methods
A total of 89 patients suffering from whiplash injury were included. They were randomly assigned into 2 groups: group
A (study group), and group B (control group). The test group was prescribed with diazepam 5 mg tablets one time per day for 7 days and the control group did not get the recommendation to use diazepam. Three previously validated scales, Visual Analogue Pain Scale (VAS), the Neck Disability Index (NDI), and the Whiplash Disability Questionnaire (WDQ), were used at different intervals (7 days, 6 weeks and 6 months after the injury).
Results
Among 89 patients, 50 (56.2%) were males, 39 (43.8%) females. The mean age of all participants was 34.80±12.531 years. According to the Mann Whitney U –Test, no significant difference was observed in VAS, NDI, and WDQ scores between the control group and study group at any time point (p>0.05).
Conclusion
Diazepam provides no substantial advantage in the treatment of whiplash, and accordingly, we do not recommend diazepam therapy in patients who suffered whiplash injury. The trial was registered in the database of the Federal National Library of Medicine (NLM) (https://clinicaltrials.gov) under clinical trials (unique protocol ID:1703016).

References

1.
Spitzer W. Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining" whiplash" and its management. Spine. 1995. p. 1S – 73.
2.
Benites M, Pérez-Garrigues H, Pérez C. Clinical symptoms of equilibrium disorders in patients with whiplash syndrome. Acta Otorrinolaringol Esp. 2009. p. 155–9.
3.
Tanaka N, Atesok K, Nakanishi K, Kamei N, Nakamae T, Kotaka S, et al. Pathology and treatment of traumatic cervical spine syndrome: whiplash injury. Adv Orthop. 2018. p. 1–6.
4.
Barnsley L, Lord S, Bogduk N. Whiplash injury. Pain. 1994. p. 283–307.
5.
Vincent M. Cervicogenic headache: a review comparison with migraine, tension-type headache, and whiplash. Curr Pain Headache Rep. 2010. p. 238–43.
6.
Endo K. Whiplash Injury Handbook. Springer; 2006.
7.
Benoist M, Rouaud J. Whiplash: myth or reality? Joint Bone Spine. 2002. p. 358–62.
8.
Deans G, Magalliard J, Kerr M, Rutherford. Neck sprain-a major cause of disability following car accidents. Injury. 1987. p. 10–2.
9.
Ritchie C, Sterling M. Recovery pathways and prognosis after whiplash injury. J Orthop Sports Phys Ther. 2016. p. 851–61.
10.
Sterling M. Whiplash-associated disorder: musculoskeletal pain and related clinical findings. J Man Manip Ther. 2011. p. 194–200.
11.
Styrke J, Sojka P, Björnstig U, Stålnacke B. Symptoms, disabilities, and life satisfaction five years after whiplash injuries. Scand J Pain. 2014. p. 229–36.
12.
Carroll L, Hogg-Johnson S, Côté P, Van Der Velde G, Holm L, Carragee E, et al. Course and prognostic factors for neck pain in workers: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine. 2008. p. 93–100.
13.
Carroll L, Holm L, Hogg-Johnson S, Côté P, Cassidy J, Haldeman S, et al. Course and prognostic factors for neck pain in whiplash-associated disorders (WAD): results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Eur Spine J. 2008. p. 83–92.
14.
Burton K. Proceeding of Whiplash 2003 Conference, Bath/England. Lyons Davidson Solicitors; 2003.
15.
Kumagai G, Wada K, Tanaka S, Asari T, Koyama K, Oyama T, et al. Prevalence of whiplash injury and its association with quality of life in local residents in Japan: A cross sectional study. J Orthop Sci. 2021. p. 30372–9.
16.
Eck J, Hodges S, Humphreys S. Whiplash: a review of a commonly misunderstood injury. Am J Med. 2001. p. 651–6.
17.
Connelly L, Supangan R. The economic costs of road traffic crashes: Australia, states and territories. Accid Anal Prev. 2006. p. 1087–93.
18.
Galasko C. Incidence of whiplash associated disorder. BC Med J. 2002. p. 237–40.
19.
Ritchie C, Hollingworth S, Warren J, Sterling M. Medicine use during acute and chronic postinjury periods in whiplash-injured individuals. Pain. 2019. p. 844–51.
20.
Khwaja S, Minnerop M, Singer A. Comparison of ibuprofen, cyclobenzaprine or both in patients with acute cervical strain: a randomized controlled trial. CJEM. 2010. p. 39–44.
21.
Dhaliwal J, Rosani A, Saadabadi A, Diazepam. StatPearls. Treasure Island (Forida): StatPearls Publishing. 2021.
22.
Bijur P, Silver W, Gallagher E. Reliability of the Visual Analog Scale for Measurement of Acute Pain. Acad Emerg Med. 2001. p. 1153–7.
23.
Revill S, Robinson J, Rosen M, Hogg M. The reliability of a linear analogue for evaluating pain. Anaesthesia. 1976. p. 1191–8.
24.
Stiell I, Wells G, Vandemheen K, Clement C, Lesiuk H, Maio D, et al. The Canadian Cspine rule for radiography in alert and stable trauma patients. Jama. 2001. p. 1841–8.
25.
Haefeli M, Elfering A. Pain assessment. Eur Spine J. 2006. p. 17-S24.
26.
Vernon H. The Neck Disability Index: State-of-the-Art. J Manipulative Physiol Ther. 1991. p. 491–502.
27.
Stupar M, Côté P, Beaton D, Boyle E, Cassidy J. A test-retest reliability study of the Whiplash Disability Questionnaire in Patients With Acute Whiplash-Associated Disorders. J Manipulative Physiol Ther. 2015. p. 629–36.
28.
Friedman B, Irizarry E, Solorzano C, Khankel N, Zapata J, Zias E, et al. Diazepam is no better than placebo when added to naproxen for acute low back pain. Ann Emerg Med. 2017. p. 169–76.
29.
Brötz D, Maschke E, Burkard S, Engel C, Mänz C, Ernemann U, et al. Is there a role for benzodiazepines in the management of lumbar disc prolapse with acute sciatica. Pain. 2010. p. 470–5.
30.
Peloso P, Khan M, Gross A, Carlesso L, Santaguida L, Lowcock J, et al. Pharmacological interventions including medical injections for neck pain: an overview as part of the ICON Project. Open Orthop J. 2013. p. 473.
31.
Cameron I, Harvey L, Ierano J, Jagnoor J, Perry K, Rebbeck T, et al. Guidelines for the Management of Acute Whiplash Associated Disorders for Health Professionals. 2014.
32.
Siegmund G, Winkelstein B, Ivancic P. Svensson MY, Vasavada A. The anatomy and biomechanics of acute and chronic whiplash injury. Traffic Inj Prev. 2009. p. 101–12.
33.
Evans W, Meredith C, Cannon J, Dinarello C, Frontera W, Hughes V, et al. Metabolic changes following eccentric exercise in trained and untrained men. J Appl Physiol. 1986. p. 1864–8.
34.
Nederhand M, Hermens H, Ijzerman M, Turk D, Zilvold G. Cervical muscle dysfunction in chronic whiplash-associated disorder grade 2: the relevance of the trauma. Spine. Phila; 1976. p. 1056–61.
35.
Klein G, Mannion A, Panjabi M, Dvorak J. Trapped in the neutral zone: another symptom of whiplash-associated disorder? Eur Spine J. 2001. p. 141–8.
36.
Seldenrijk A, Vis R, Henstra M, Ho Pian K, Van Grootheest D, Salomons T, et al. Systematic review of the side effects of benzodiazepines. Ned Tijdschr Geneeskd. 2017. p. 1052.
37.
Chatterjee D, Iliffe S, Kharicha K, Harari D, Swift C, Gillman G, et al. Health risk appraisal in older people 7: long-acting benzodiazepine use in community-dwelling older adults in London: is it related to physical or psychological factors? Prim Health Care Res Dev. 2017. p. 253–60.

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