To identify prognosis factors that enable us to spot patients with risk of developing chronic symptoms and disabilities after a whiplash. The prognosis factors for poor recovery in acute whiplash aren’t conclusive. We enclosed 557 patients who suffered whiplash after road traffic accident and visited the Department of Physical medicine and Rehabilitation of Mataró Hospital (Spain) for medical analysis and rehabilitation treatment. The variables were collected following a protocol designed for the study, and all patients were assessed through the Visual Analogue Scale (VAS) for the intensity of neck pain, the goldberg Depression and Anxiety Scale and therefore the Northwick Park Neck Pain form (NPH) for cervical column practicality at initial analysis and 6 months later. Factors connected with VAS 6 months after the whiplash were ladies, age, number of days of cervical column immobilization, previous neck pain, freelance staff, housewives, pensioners, students, presence of headache or symptom, and VAS, Goldberg Depression and Anxiety scale, and NPH scores at initial analysis. In multivaried analysis, it had been found that the variables that had influence on VAS 6 months after the whiplash were statistically vital for age, presence of symptom, freelance staff, and VAS and NPH scores at initial analysis. Our findings indicate that factors that enable us to spot patients in danger for poor recovery are age, dizziness, and initial analysis of neck pain with VAS and cervical column practicality with NPH.
Recent analysis has shown that temporomandibular symptoms could also be related to or occur independently of whiplash-associated disorders associated with motor-vehicle collisions. A PubMed/Medline search was conducted using the terms “temporomandibular disorders,” “orofacial pain,” “temporomandibular joint,” “whiplash,” and “whiplash-associated disorders and motor-vehicle accidents and motor-vehicle collisions” for the years 1995 to 2009. Systematic reviews, meta-analyses, and clinical studies were enclosed if they addressed temporomandibular disorders, whiplash medicine, diagnosis, and prognosis. References within the hand-picked articles were additionally reviewed (including those before 1995) if the articles specifically addressed the subject. an evidence base was established for general outcomes using the Oxford Centre for proof-Based medication Levels of Evidence. Temporomandibular symptoms might develop following motor-vehicle collisions and be a lot of advanced, representing a element of a symbol cluster of probably regional and widespread pain wedged by psychosocial factors. Oral health care suppliers should bear in mind of the link between temporomandibular symptoms, whiplash-associated disorders, and trauma and therefore the a lot of advanced nature of the symptoms for acceptable diagnosis and management.
To compare the effectiveness of acupuncture with simulated acupuncture in patients with acute and chronic whiplash-associated disorders. Acupuncture is widely used for the treatment of neck and other musculoskeletal pain, and there’s some proof supporting its effectiveness for short pain relief. The effectiveness of acupuncture within the treatment of whiplash-associated disorders isn’t clear. A total of 124 patients between eighteen and sixty five years with chronic (85%) or acute whiplash-associated disorders (Grade I or II) were arbitrarily allotted to real or simulated acupuncture treatment for 12 sessions throughout a 6-week amount. each treatments concerned skin penetration with acupuncture needles and were provided by one university-trained acupuncturist in a University Clinic in Sydney, Australia. Primary outcome measures were pain intensity (10-cm visual analog scale), incapacity (Neck incapacity Index), and health-related quality of life (SF-36). Secondary outcomes were patient-specific activity scales, and therefore the McGill Pain Rating Index. Mean initial pain intensity for all participants was 5.6 cm. Participants receiving the $64000 acupuncture treatment had considerably bigger reduction in pain intensity at 3 and 6 months, 0.9 cm (P = 0.05) and 1.3 cm (P = 0.007), respectively, compared to the acupuncture cluster. when adjustment for baseline standing, there was no vital reduction in incapacity, or improvement in health-related quality of life. There was an improvement within the activity scales of the same size to the reduction in pain, however no distinction within the McGill Index. Real acupuncture was related to a major reduction in pain intensity over a minimum of vi months. This reduction was most likely not clinically vital. There was no improvement in incapacity or quality of life.
Not much information is available when it comes to gender differences in coping after a whiplash. Up to the present day, the association between a person’s gender and the ability to cope have not been fully studied. This current study aims to determine if gender has something to do with a person’s ability to cope with long-lasting neck pain following a whiplash. Seven hundred and forty participants referred from emergency departments or general practitioners after car accidents in Denmark. Within a median of five days, post-collision participants completed questionnaires on collision characteristics, psychological distress, and socio-demographics. After 3 months they completed the Coping Strategies Questionnaire, and after 12 months a VAS scale on neck pain intensity.The odds for long-lasting neck pain were more than twice as high for women than for men (OR = 2.17 (95% CI: 1.40; 3.37). However, no gender difference in coping and no interaction between gender and the five coping subscales on neck pain after 12 months were found. ‘Distraction’ increased the odds for considerable neck pain for both men and women (OR = 1.03 (95% CI: 1.01; 1.05), ‘reinterpreting’ (OR = 1.03 (95% CI: 1.01; 1.06), ‘catastrophizing’ (OR = 1.14 (95% CI: 1.10; 1.18), and ‘praying and hoping’ (OR = 1.10 (95% CI: 1.05; 1.13) for each point on these scales.The results showed that there is no relation between coping and gender on neck pain. The different coping strategies 3 months post-collision did not explain the different prognosis observed in men and women.
There is a possibility of coming up with a short assessment tool that can be used to measure the recovery of musculoskeletal injuries. The goal of this study was to find information on the relation of a one-item global self-assessment of recovery to commonly used measures of recovery status. The study followed a total of 6, 021 adults who are suffering from acute WAD for a period of 6 months. Pain, depression, work status and physical health were assessed at baseline and follow-up. The question “How do you feel you are recovering from your injury?” (six response options from “all better” to “getting much worse”) and functional limitations were administered at follow-up. The responses to the recovery question were related to the other factors used. Those “all better” had the lowest pain intensity, pain-related limitations, depression and work disability, and the best general physical health. Incrementally poorer recovery ratings on the recovery question were associated with greater pain, functional limitations and depression, poorer physical health and being off work, although “no improvement” and “getting a little worse” were similar. Recovery categories also reflected different degrees of actual improvements over the preceding follow-up period.
Although pain ca be considered a subjective symptom, it must be investigated, questioned and evaluated in accordance with carrying out of an orthopedic examination. A number of subjective symptoms can be used in an objective manner by measuring the effects of pain on one’s ability to carry out daily chores. The specific location and quality of pain as well as the ability to replicate with consistency the reporting of pain to the examiner need to be considered.
It is important to remember that since a sign of non-lingering is the inconsistency in reporting of pain symptoms then a logical explanation is that consistency of a patient’s complaints leads to objectivity to their injury.
Here are a few terminologies that may come in handy:
Oriental practice of inserting needles into the skin at points (Meridians) of the body to help relieve pain and treat illness.
Sharp or intense short-term pain. Typically follows injury or surgery.
Psychological or emotional need for a drug. Associated with cravings and inappropriate efforts to obtain the drug.
The sensation of pain triggered by a stimulus to the skin that is normally not painful (e.g., lightly touching a sunburn).
Absence or decreased pain response to stimulation that would normally be painful.
Medicine used to relieve pain.
Absence or partial loss of sensation.
An agent (or agents) that reversibly produce anesthesia.
A medicine that reduces inflammation.
Disorder or disease of a joint.
Pain in or affecting a joint.
Intense pain and sensitivity usually following injury to a peripheral nerve.
Pain associated with a lesion or dysfunction of the central nervous system.
The opposite of acute pain. Persistent, long-term pain.
Pain due to the loss of normal sensory input into the central nervous system.
An area of skin supplied by fibers of a single nerve root.
An abnormal, unpleasant sensation.
An injection into the outer layer of the spinal canal (the epidural space).
Increased sensitivity to pain.
Abnormal, acute sensitivity to sensory stimulation of the skin.
Diminished sensitivity to sensory stimulation of the skin.
Usually refers to opioids–pain-relieving drugs that are derivatives of opium.
An injection of medication directly into or around a nerve or group of nerves to provide regional pain relief.
Pain in the distribution of a nerve or nerves and caused by nerve damage or dysfunction.
Inflammation of a nerve or nerves.
Pain originating from the malfunctioning of the nervous system.
Disturbance of function or pathologic change in one or more nerves.
Response to a painful stimulus.
A sensory nerve receptor that responds to pain.
A stimulus that is harmful or potentially harmful to body tissue, and triggers a painful or unpleasant sensation.
Opioid or Opiate
A pain-killing drug chemically related to opium.
An unpleasant feeling that may be associated with disease or trauma.
The most minimal stimulation that a person recognizes as painful—this varies from individual to individual.
Pain Tolerance Level
The greatest amount of pain a person can tolerate.
An abnormal sensation such as tingling or ‘pins and needles’ that may be uncomfortable, but not truly painful.
Inflammation of a nerve root in the spinal canal.
Pain and neurologic deficit caused by injury to a nerve root.
Pain felt in a body part that is distant from the pain origin. The origin and the body part may share a common nerve pathway.
Surgical incision of nerve root(s) within the spinal canal.
Sensory signals from the body—usually referring to signals from the limbs rather than internal organs.
An area in muscle or connective tissue that is hypersensitive to touch or pressure.
The impact of two cars against each other exerts thousands of pounds of force and a lot of that force is transmitted to the neck and spine of the persons involved. The gravity of the injury will depend on how bad the impact was, and speed will always play a vital role. Where the person was seating as well as how many passengers were there during the accident are also very important factors. Seat belts too, determine the degree of injury and our accident injury treatment team is well aware of the soft tissue damage that belts can sometimes cause.
More often that not, there is injury to the cervical spine due to the weight of the head moving rapidly forward and back (what we refer to as whiplash). In the event that the head hits something inside the car, further injuries could occur such as Post-Concussion syndrome. Symptoms may occur right away. In some cases, however, symptoms may not fully show until about 24-48 hours after the accident. Emergency room treatment on its own might not fully reveal the injuries caused.
When we use the term whiplash in pointing out the injuries caused by an accident, it often generates grave feelings of fear that include psychological consequences. Injuries of this type can easily be treated. That’s why it is so important the accident victim seeks experienced specialists when such injury is present or suspected.
Pain is the major symptom in this type of injury. And, sometimes muscles react even when not directly involved. The result is hypertension and muscle pain which sets up a vicious cycle with the nerves of the spinal cord, this increases muscle tension, which increases pain and further tension. Skeletal and muscular injuries heal quicker if treatment is started early.
*Foraminal Compression (Cervical Spine): Laterally bend the head with mild pressure toward the side of complaint and then press downward. AN increase or radiation of pain into the arm will indicate narrowing of the cervical foramina caused by degenerative joint disease or disc damage.
*Soto Hall Test (Cervical Spine): Patient laying flat on back lifts head flexing it onto the chest with the other hand placed on the sternum for counter pressure. Patient is able to localize neck pain to the involved segments.
*Shoulder Depression (Cervical Spine): Laterally bend head then push downward on the shoulder. Test causes traction on the cervicothoracic muscle groups as well as nerve root tension/traction.
Kemp’s Test (Dorsolumbar Spine): Bend back obliquely with the patient in a standing position. It can also be preformed in a seated position. If pain radiates down sciatic nerve on the side that the patient is bending toward, it can indicate disc involvement or dermatomal allocation of pain.
Fabere’s Test (Lumbar Spine/Hip): Place the malleolus of the ankle on the opposite knee and push down on the knee. Positive of hip joint lesions when unable to do or causes great pain. The test can indicate sacroiliac lesions when it causes lower back pain.
Yeoman’s Test (Lumbar Spine): With the patient in a prone position, place pressure over the lower lumbar spine on the left side while raising the left hip into passive hip extension. Positive results indicate inflammation and lesion in the lumbar spine and potentially in the sacroiliac joint on the same side of the testing.
Almost everybody will go through neck and back pain at some point in their lives. As a matter of fact, musculosketal pain, is one of the most common reasons why people seek medical treatment. Your neck and back pain could be the result of a number of conditions from simple muscle strain to the presence of a tumor or infection.
Acute physical trauma is one of the most common causes of neck and back pain. In severe cases, the person may also feel numbness and tingling sensations in the hands and arms, and legs and feet along with neck and back pain . More often than not, these problems are associated to the spine rather than just to the muscles. Nerves and nerve roots, connective tissue, vertebrae and discs or other structures of the back may be affected. This pain is more serious, lasts longer, and requires professional intervention and treatment.
Disc herniations are a cause of spinal pain that most often occur in the lumbar and cervical areas of the spine. The herniation applies pressure to spinal nerve roots and can cause neurological symptoms together with pain. Symptoms may be numbness, tingling, burning, or a feeling like an electric shock running down the arms and/or legs and continue into the hands and feet. Motor weakness and complications may also be a possibility.
The Multi-Disciplinary Approach:
- Physiatry – Otherwise known as physical medicine and rehabilitation medicine, Physiatrists are medical doctors with specialized training in the evaluation and nonsurgical management of spinal disorders. Physiatrists are trained in the following areas: diagnostic evaluation, diagnostic and therapeutic spinal and soft tissue injections, pharmacologic (medication) treatment, biomechanical (physical function) evaluation, exercise prescription, injury assessment, spinal bracing, and medical acupuncture.
- Chiropractic/Manual Treatment – manual spinal intervention techniques such as joint mobilization and manipulation, therapeutic exercise development, biomechanical analysis, job site and task analysis, ergonomic consultation, and patient education.
- Anesthesiology and Pain Management – provides both diagnostic and therapeutic spinal injections, acupuncture, and other non-surgical methods of controlling pain such as Trigger point injections are also provided.
- Radiology – Diagnostic imaging, using techniques such as MRI and CAT scans as well as interventional injection techniques
- Neurology – Referrals to Neurologists who specialize in the evaluation and management of pain, numbness, and weakness that may be caused by degenerative, inflammatory, infectious, and autoimmune disorders involving the spinal cord or its nerve roots are occasionally needed.
The impact of 2 cars exerts thousands of pounds of force and consequently abundant of that force is transmitted to the neck and spine. Frequently, there’s injury to the cervical spine owing to the load of the top snapping forward and back. so the term: whiplash. If the top strikes one thing within the automotive there may be further injuries like Post-Concussion syndrome. Some symptoms of injury may show up forthwith however others might not seem for weeks or months. ER treatment may not absolutely reveal these injuries.
Some common symptoms of whiplash and Post-Concussion Syndrome are:
• Neck pain and restriction of movement
• Headache that won’t go away
• Tiredness and feelings of nervousness
• Trouble with balance, equilibrium
• Ringing in the ears
• Inability to sleep and excessive sweating.
• Numbness in extremities.
• Inability to concentrate or memory loss
The objective of the study is to spot risk factors for chronic incapacity in individuals with acute whiplash associated disorders (WAD) and to estimate the impact of the numbers of risk factors gift. Prospective cohort study. information were collected, on average, thirty two days once injury (SD=10.9) and twelve months later. Baseline measures of pain, disability, neck movement, psychological and behavioral factors were independent variables and chronic incapacity at twelve months was the variable in an exceedingly multi variable supplying multivariate analysis.Participants (n=599) with symptoms three weeks once injury, self-referred to therapy as a part of a irregular controlled trial. 430 (72%) participants provided complete information for this analysis. 136 (30%) participants developed chronic incapacity. High baseline incapacity (OR three.3, 95% CI 1.97 to 5.55), longer foreseen recovery time (OR two.4, 95% CI 1.45 to 3.87), psychological distress (OR one.9, 95%CI 1.05 to 3.51), passive cope (OR one.8, 95% CI 1.07 to 2.97) and bigger variety of symptoms (OR one.7, 95% CI 1.07 to 2.78) were related to chronic incapacity. One risk issue resulted in three.5 times the danger (95% CI one.04 to 11.45) of chronic incapacity however this risk multiplied to sixteen times (95%CI five.36 to 49.27) in those with four or 5 risk factors. Baseline incapacity had the strongest association with chronic incapacity however psychological and behavioral factors were conjointly necessary. Treatment ways ought to replicate this which can need a amendment to current therapy approaches for acute WAD. the quantity of risk factors gift ought to be thought-about once evaluating potential for poor outcome.