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Age-related differences in recovery from pain due to motor vehicle collision: a prospective longitudinal study

      Motor-vehicle collisions (MVCs) are a common cause of injury among adults of all ages and frequently result in persistent pain. Data from other settings suggest that recovery from an acute painful condition may take longer in older adults than in younger adults. We analyzed data from a prospective study of adults experiencing MVC to examine recovery from an acute pain condition across the adult lifespan. European Americans presenting to one of eight emergency departments (EDs) after MVC without fracture or injury requiring admission were enrolled. Pain severity was evaluated in-person in the ED and by phone six weeks after the MVC using a 0-10 scale. Multivariable linear regression was used to assess the relationship between patient age group, represented as 10-year interval categories, and pain recovery, defined as the change in pain from the ED to the six week assessment, adjusting for patient sex, vehicle damage, and pain in the month prior to the MVC. Of 705 patients with complete ED and six week data who had not hired a lawyer at 6 weeks, 541 patients (77%) had moderate or severe pain (pain score >4) in the ED. Among these patients, pain recovery decreased with advancing age group (p<.01). After adjusting for patient sex, vehicle damage, and pain in the month prior to the MVC, the relationship between age group and pain recovery persisted, with generally lower mean decreases in pain for older than younger age groups: age 18-24=3.2 (95% CI 2.7-3.6); 25-34=3.0 (2.6-3.5); 35-44=1.9 (1.4-2.5); 45-54=2.3 (1.7-3.0); 55-64=2.1 (1.3-2.8); >65=1.9 (0.9-2.9); p<.005. Further research is needed to characterize and understand the social, psychological, and biological factors contributing to reduced recovery from acute musculoskeletal pain after injury in older adults. Supported by NIAMS R01AR056328 and NCRR KL2 TR000084.