Abstract: Objectives: The objective of the current study was to examine the effect of a daily pain diary on recovery from acute whiplash injury. Design: Cohort-controlled study. Setting: Primary care clinic. Participants: A total 56 of 60 initially-recruited subjects were seen in follow-up three months post-injury, 27 in the Diary group and 29 in the Control group. Summary of Background Data: Symptom diaries are often recommended to or used by patients suffering with acute whiplash injury. Diaries have been shown to be associated, however, with symptom amplification in healthy subjects. The effect of diary use on recovery from injury is unknown. Interventions: Subjects with acute whiplash injury were randomly assigned to one of two groups: a Diary group and Control group. Primary outcome measures: Data was gathered within one week of injury on gender, age, and whiplash Disability Questionnaire scores. The Diary group was asked then to keep a record of their overall pain experience, rating their pain on a scale of 1–10 on a daily basis for four weeks. Results: At the outset, both groups had similar mean age, gender distribution, and mean whiplash Disability Questionnaire scores. After four weeks of pain diary use, fewer Diary group subjects reported recovery at three months compared to the Control group (59% versus 86%, respectively, p<0.05). Conclusions: The use of a pain diary for four weeks in acute whiplash-injured subjects is associated with a reduced rate of recovery.

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