Taking Position after WhiplashWe've all seen someone who can't move the neck after a whiplash injury. Pain and loss of motion are common in the early days after the injury. But why do some people end up with chronic pain and others don't?
This is the focus of a new study from the Whiplash Research Unit in Australia. Research has shown changes in other parts of the spine after whiplash in patients with chronic pain. It's thought that such changes only affect some patients. Studies also show that higher levels of pain and disability right after an accident may lead to chronic whiplash.
In this study, motor function, changes in sensory input, and psychological factors were measured. There were 80 whiplash patients included. The researchers looked for differences in the three measures among patients with mild, moderate, and severe pain.
All whiplash injuries occurred within the last 30 days. The injured patients were compared to a control group of 20 uninjured subjects. Range of motion and joint position error (JPE) were measured using a special device and custom computer program. JPE is the ability to return the head to its natural position after turning it from side to side or up and down. Other measures included pain, temperature, and psychological distress.
The results showed that all whiplash groups had less motion than the control group. The groups with moderate or severe symptoms had greater JPEs than the group with mild pain. All patients had psychological distress. But distress was greater after moderate and severe injuries. Motor or sensory changes weren't related to psychological distress. The severely injured group was more limited socially. They also had more anxiety and trouble sleeping.
The authors conclude that changes occur in the nervous system and muscle activation soon after a whiplash injury. These changes are likely caused by injured structures in the head and neck. Patients with more severe pain seem to be more sensitive to these changes than those with mild symptoms. The changes in the nervous tissue, not psychological distress, account for more extreme symptoms in some people after a whiplash injury.
Michele Sterling, PhD, et al. Characterization of Acute Whiplash-Associated Disorders. In Spine. January 15, 2004. Vol. 29. No. 2. Pp. 182-188.
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