A Distinct Pattern of Findings in Patients After Whiplash Injury
A Distinct Pattern of Findings in Patients After Whiplash Injury
New Research – 2008
Patients that are involved in motor vehicle accidents often complain about headache, brachialgia (pain radiating into 1 or both arms), vertigo or dizziness, chewing and swallowing problems, visual-motor disturbances, such as blurred vision and reduced coordination, fatigue and reduced energy, neuropsychologic dysfunction, depression, irritability, and sleep disorders. On clinical examination, reduced range of motion of the cervical spine is prevalent. One can distinguish between the mobility of the upper cervical spine and the mobility of the lower cervical spine by using an inclinometer as a visual finding. However, this is not deemed the method of choice by the American Medical Association.
Ettlin et al. (2008) concluded that patients with whiplash disorders would display more trigger points in the upper neck, on the basis of the biomechanics of the injury and the findings by Barnsley and Lord10 S.M. Lord, L. Barnsley, B.J. Wallis and N. Bogduk, Chronic cervical zygapophysial joint pain after whiplash: a placebo-controlled prevalence study, Spine 21 (1996), pp. 1737–1744. Full Text via CrossRef and colleagues. The results showed 85.1% of the patients with whiplash had positive trigger points in the upper cervical spine at the base of the skull when compared to the control groups. The paper concluded that whiplash syndrome showed a distinct pattern of muscle spasm distribution that differed significantly from other patient groups and healthy subjects, establishing a causal relationship to the accident.
It is critical that each patient undergo a thorough clinical examination to correlate causality to bodily injury and persistent functional loss. There is no “canned” algorithm for whiplash patients that have stood the test of academic and clinical scrutiny necessitating an individual examination.
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Reference:
Ettlin, T., Schuster, C., Stoffel, R., Brüderlin, A., & Kischka, U. (2008). A distinct pattern of myofascial findings in patients after whiplash injury. Archives of Physical Medicine and Rehabilitation, 89(7), 1290-1293.