Houston Methodist. Leading Medicine

Neck FAQ

Question:

I feel like a zombie. I can't turn my head and neck more than a tiny bit or the pain shoots up from a three to a 10. If I even touch the tops of my shoulders, it is very painful. I did have a car wreck and a whiplash but that was a month ago. Why can't I seem to get over this hump?

Answer:

You may be experiencing a pain-spasm cycle of chronic whiplash known as whiplash-associated disorders (WAD). And as a result, you may have developed trigger points (TrPs) that are keeping the pain at such high levels. Trigger points (TrPs) are hyperirritable spots in the muscle caused by muscle immobilization (e.g., in a cast or splint or as a result of pain from an accident) or overuse (repetitive motion). When active, these points create painful muscles and limited range-of-motion. Trigger points develop along with whiplash-associated disorder as a result of something called central sensitization. Central sensitization is a hyperexcitability of the central nervous system. In other words, when present, TrPs "revv" up the engine of the nervous system and it doesn't slow down when the foot is taken off the accelerator. But there may be more to it than that as some research has shown a bidirectional mechanism. Input from TrPs to the nervous system increase pain sensitivity and vice versa. Increased sensitivity of the nervous system to stimuli may actually create the TrPs. In situations like these, the affected individual's pressure pain threshold, a measure of how much pressure it takes to create a painful response is lowered. Small amounts of pressure result in high levels of pain. This is referred to as pressure pain hypersensitivity, which may be what you are experiencing. Treating TrPs may be one way to reduce your pain. You may want to see a physical therapist and/or an acupuncturist to get started. Follow-up with massage may help dissipate some of the waste products that build up in muscles that are constantly contracting in pain. The therapist will also provide you with some stretching and strengthening exercises to help in the recovery process. It may take four to six weeks but stick with it and you should see some good results. Antonio Manuel Fernández-Pérez, PT, MSc, et al. Muscle Trigger Points, Pressure Pain Threshold, and Cervical Range of Motion in Patients with High Level of Disability Related to Acute Whiplash Injury. In Journal of Orthopaedic & Sports Therapy. July 2012. Vol. 42. No. 7. Pp. 634-641.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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