-
Europa Medicophysica Mar 2007Nonspecific (simple) neck pain is the commonest cause of neck symptoms and results from postural and mechanical causes. It includes pain following whiplash injury... (Review)
Review
Nonspecific (simple) neck pain is the commonest cause of neck symptoms and results from postural and mechanical causes. It includes pain following whiplash injury provided there is no bony injury or objective neurological deficit. The anatomy of the cervical spine is described, with the degenerative changes that are seen in patients with nonspecific neck pain, but also occur with ageing. The poor correlation between the degree of degeneration and presence and severity of symptoms is noted. A lack of specific pathology is also a feature of whiplash. The epidemiology, clinical presentation, investigation, and complications of nonspecific neck pain are described with a discussion of the controversial aspects of natural history, prognosis and therapy. Chronic whiplash is very common in some countries, but nonexistent in other countries and the factors which might explain this difference are considered. There is a great need for better quality studies to explore pathogenesis, natural history and factors including therapy that influence outcome.
Topics: Cervical Vertebrae; Diagnosis, Differential; Humans; Neck Pain; Whiplash Injuries
PubMed: 17369782
DOI: No ID Found -
Chinese Journal of Traumatology =... Oct 2009Despite a large number of rear-end collisions on the road and a high frequency of whiplash injuries reported, the mechanism of whiplash injuries is not completely... (Review)
Review
Despite a large number of rear-end collisions on the road and a high frequency of whiplash injuries reported, the mechanism of whiplash injuries is not completely understood. One of the reasons is that the injury is not necessarily accompanied by obvious tissue damage detectable by X-ray or MRI. An extensive series of biomechanics studies, including injury epidemiology, neck kinematics, facet capsule ligament mechanics, injury mechanisms and injury criteria, were undertaken to help elucidate these whiplash injury mechanisms and gain a better understanding of cervical facet pain. These studies provide the following evidences to help explain the mechanisms of the whiplash injury: (1) Whiplash injuries are generally considered to be a soft tissue injury of the neck with symptoms such as neck pain and stiffness, shoulder weakness, dizziness, headache and memory loss, etc. (2) Based on kinematical studies on the cadaver and volunteers, there are three distinct periods that have the potential to cause injury to the neck. In the first stage, flexural deformation of the neck is observed along with a loss of cervical lordosis; in the second stage, the cervical spine assumes an S-shaped curve as the lower vertebrae begin to extend and gradually cause the upper vertebrae to extend; during the final stage, the entire neck is extended due to the extension moments at both ends. (3) The in vivo environment afforded by rodent models of injury offers particular utility for linking mechanics, nociception and behavioral outcomes. Experimental findings have examined strains across the facet joint as a mechanism of whiplash injury, and suggested a capsular strain threshold or a vertebral distraction threshold for whiplash-related injury, potentially producing neck pain. (4) Injuries to the facet capsule region of the neck are a major source of post-crash pain. There are several hypotheses on how whiplash-associated injury may occur and three of these injuries are related to strains within the facet capsule connected with events early in the impact. (5) There are several possible injury criteria to correlate with the duration of symptoms during reconstructions of actual crashes. These results form the biomechanical basis for a hypothesis that the facet joint capsule is a source of neck pain and that the pain may arise from large strains in the joint capsule that will cause pain receptors to fire.
Topics: Biomechanical Phenomena; Cervical Vertebrae; Female; Humans; Male; Neck; Shear Strength; Whiplash Injuries
PubMed: 19788851
DOI: No ID Found -
Scandinavian Journal of Pain Apr 2022Acute as well as chronic pain syndromes are common after whiplash trauma and exercise therapy is proposed as one possible intervention strategy. The aim of the present... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Acute as well as chronic pain syndromes are common after whiplash trauma and exercise therapy is proposed as one possible intervention strategy. The aim of the present systematic review was to evaluate the effect of exercise therapy in patients with Whiplash-Associated Disorders for the improvement of neck pain and neck disability, compared with other therapeutic interventions, placebo interventions, no treatment, or waiting list.
CONTENT
The review was registered in Prospero (CRD42017060356) and conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A literature search in PubMed, Scopus and Cochrane from inception until January 13, 2020 was combined with a hand search to identify eligible randomized controlled studies. Abstract screening, full text assessment and risk of bias assessment (Cochrane RoB 2.0) were conducted by two independent reviewers.
SUMMARY
The search identified 4,103 articles. After removal of duplicates, screening of 2,921 abstracts and full text assessment of 100 articles, 27 articles that reported data for 2,127 patients were included. The included articles evaluated the effect of exercise therapy on neck pain, neck disability or other outcome measures and indicated some positive effects from exercise, but many studies lacked control groups not receiving active treatment. Studies on exercise that could be included in the random-effect meta-analysis showed significant short-term effects on neck pain and medium-term effects on neck disability.
OUTLOOK
Despite a large number of articles published in the area of exercise therapy and Whiplash-Associated Disorders, the current evidence base is weak. The results from the present review with meta-analysis suggests that exercise therapy may provide additional effect for improvement of neck pain and disability in patients with Whiplash-Associated Disorders.
Topics: Chronic Pain; Exercise Therapy; Humans; Neck; Neck Pain; Whiplash Injuries
PubMed: 34561976
DOI: 10.1515/sjpain-2021-0064 -
Journal of Physiotherapy Mar 2014
Review
Topics: Disease Management; Humans; Patient Care Team; Patient Education as Topic; Physical Therapy Modalities; Prognosis; Recovery of Function; Treatment Outcome; Whiplash Injuries
PubMed: 24856935
DOI: 10.1016/j.jphys.2013.12.004 -
The Journal of Bone and Joint Surgery.... Jul 2009This review discusses the causes, outcome and prevention of whiplash injury, which costs the economy of the United Kingdom approximately pound 3.64 billion per annum.... (Review)
Review
This review discusses the causes, outcome and prevention of whiplash injury, which costs the economy of the United Kingdom approximately pound 3.64 billion per annum. Most cases occur as the result of rear-end vehicle collisions at speeds of less than 14 mph. Patients present with neck pain and stiffness, occipital headache, thoracolumbar back pain and upper-limb pain and paraesthesia. Over 66% make a full recovery and 2% are permanently disabled. The outcome can be predicted in 70% after three months.
Topics: Accidents, Traffic; Compensation and Redress; Disability Evaluation; Female; Humans; Male; Neck Pain; Time Factors; United Kingdom; Whiplash Injuries
PubMed: 19567844
DOI: 10.1302/0301-620X.91B7.22639 -
BMJ (Clinical Research Ed.) Sep 1990
Review
Topics: Humans; Neck Injuries; Pain Management; Sprains and Strains; Time Factors; Whiplash Injuries
PubMed: 2282391
DOI: 10.1136/bmj.301.6749.395 -
Ugeskrift For Laeger May 2023Whiplash injuries are common in Denmark affecting around 16,000 new patients annually. Approximately 50% of the casualties develop chronic symptoms and 10% become... (Review)
Review
Whiplash injuries are common in Denmark affecting around 16,000 new patients annually. Approximately 50% of the casualties develop chronic symptoms and 10% become disabled. Many of these patients will have contact to the healthcare system, and there is a need for structured and knowledge-based examination, diagnosis and recording of findings in all clinical settings. This review discusses which variables should be recorded in clinical practice, in order to establish the best possible foundation for a structured individualized treatment protocol of the whiplash patient.
Topics: Humans; Whiplash Injuries; Disability Evaluation; Research Design; Documentation
PubMed: 37264886
DOI: No ID Found -
Dysphagia Dec 2021Difficulty swallowing has been reported following whiplash injury; however, the reasons remain poorly understood. A possible factor may be the observed changes in...
Difficulty swallowing has been reported following whiplash injury; however, the reasons remain poorly understood. A possible factor may be the observed changes in pharyngeal volume. The current exploratory study was designed to examine the prevalence of self-reported dysphagia after whiplash and the relationship with recovery status and change in pharyngeal volume. Data were available from a longitudinal study of adults with whiplash. Data included magnetic resonance imaging (MRI) of the cervical spine, the Dysphagia Handicap Index (DHI), and Neck Disability Index (NDI) collected over four timepoints (< 1 week, 2 weeks, 3 months, and 12 months post-injury). Initial cross-sectional analysis examined 60 patients with DHI data from at least one timepoint. A second, longitudinal analysis was conducted on 31 participants with MRI, NDI, and DHI data at both early (< 1-2 weeks) and late (3-12 months) timepoints. The pharynx was contoured on axial T2-weighted MRI slices using OsiriX image processing software and pharyngeal volume (mm) was quantified. In the 60-patient cohort, prevalence of self-reported dysphagia (DHI ≥ 3) was observed in 50% of participants at least once in 12 months (M = 4.9, SD 8.16, range 0-40). In the longitudinal cohort (n = 31), mean total DHI significantly (p = 0.006) increased between early and late stages. There was no relationship (p = 1.0) between dysphagia and recovery status, per the NDI% score. Pharyngeal volume remained stable and there was no relationship between dysphagia and pharyngeal volume change (p = 1.0). This exploratory study supports the need for further work to understand the nature of dysphagia, extent of functional compromise, and the underlying pathophysiology post-whiplash.
Topics: Cross-Sectional Studies; Deglutition; Deglutition Disorders; Humans; Longitudinal Studies; Pharynx; Self Report; Whiplash Injuries
PubMed: 33386482
DOI: 10.1007/s00455-020-10233-9 -
The Journal of Bone and Joint Surgery.... Aug 2009We describe a case of type-I Arnold-Chiari malformation in a 27-year-old woman who presented on two separate occasions with an apparent whiplash injury. She developed...
We describe a case of type-I Arnold-Chiari malformation in a 27-year-old woman who presented on two separate occasions with an apparent whiplash injury. She developed debilitating symptoms after two apparently low velocity vehicle collisions. MRI revealed a type-I Arnold-Chiari malformation. She was referred for consideration of neurosurgical decompression. Type-I Arnold-Chiari malformation is the downward herniation of the cerebellar tonsils through the foramen magnum. It is usually asymptomatic but may present after apparently insignificant trauma with a wide range of possible symptoms. The protean nature of its presentation and the similarity of the symptoms to those of a whiplash injury mean that it is easily overlooked. It is, however, important that it is detected early.
Topics: Accidents, Traffic; Adult; Arnold-Chiari Malformation; Decompression, Surgical; Diagnosis, Differential; Female; Headache; Humans; Neck Pain; Whiplash Injuries
PubMed: 19651845
DOI: 10.1302/0301-620X.91B8.22266 -
Chinese Journal of Traumatology =... Apr 2019Whiplash associated disorders remain a major health problem in terms of impact on health care and on societal costs. Aetiology remains controversial including the old... (Review)
Review
PURPOSE
Whiplash associated disorders remain a major health problem in terms of impact on health care and on societal costs. Aetiology remains controversial including the old supposition that the cervical muscles do not play a significant role. This study examined the muscle activity from relevant muscles during rear-end impacts in an effort to gauge their influence on the aetiology of whiplash associated disorders.
METHODS
Volunteers were subjected to a sub-injury level of rear impact. Surface electromyography (EMG) was used to record cervical muscle activity before, during and after impact. Muscle response time and EMG signal amplitude were analysed. Head, pelvis, and T1 acceleration data were recorded.
RESULTS
The activities of the cervical muscles were found to be significant. The sternocleidomastoideus, trapezius and erector spinae were activated on average 59 ms, 73 ms and 84 ms after the impact stimulus, respectively, prior to peak head acceleration (113 ms).
CONCLUSION
The cervical muscles reacted prior to peak head acceleration, thus in time to influence whiplash biomechanics and possibly injury mechanisms. It is recommended therefore, that muscular influences be incorporated into the development of the new rear-impact crash test dummy in order to make the dummy as biofidelic as possible.
Topics: Acceleration; Accidents, Traffic; Biomechanical Phenomena; Electromyography; Head; Humans; Models, Biological; Neck Muscles; Reaction Time; Whiplash Injuries
PubMed: 30962127
DOI: 10.1016/j.cjtee.2018.10.006