Neck Pain. and Whiplash -Associated Disorders (WAD). Commonly known as “Whiplash” (WAD). Reg’d BUPA AXA HSA AVIA all health insurers
Cervicalgia
The neck muscles are constantly placed under tension, although this tension helps to keep the head in position i.e. upright. However the muscles in the neck are more prone to becoming stiff and painful as a result of this tension. As a result of violent movement or sudden impact (known sometimes as “whiplash” (WAD)).
Cervicalgia is a localised pain that does not radiate through into other areas of the neck.
Symptoms include:
· A sharp pain in the neck
· Neck ache
· Pain resulting from head movement
· Pain radiating to the shoulders, arms and fingers
It also may radiate pain into other areas; this is usually caused by a trapped nerve or nerves. Nerves can become trapped by tight muscles, disc damage, or the formation of bony deposits. Radiating pain in the neck which affects the shoulders and arms may also affect the fingers.
Neck dysfunction can result in dizziness, nausea or headaches but it can be successfully treated by Cold Laser Therapy, one of the treatments offered by Central Chiropractic Clinic
Cervicogenic headaches
Cervicogenic headaches are defined as headaches originating from the neck. The location is typically at the back of the head, sides and top of the head as well as around the forehead and eyes affecting one or more of the above regions at once. These headaches can be located on one or both sides of the head. Cervicogenic headaches are usually associated with dysfunction of the upper neck which can present itself as neck pain or local tenderness, reduced neck range of motion and exacerbation of the headaches by neck movement. The past history of neck trauma is typical for this type of headaches.
The cervicogenic headaches are caused by irritation of nerve endings of injured joints, ligaments, muscles and discs of the neck. The nerve endings in the injured areas send pain signals up the upper nerves of the neck to the brain causing “cross wiring” with the fibres of the trigeminal nerve (one of the nerves in the head) which is responsible for perception of the head pain thus causing the headaches.
Cervical Disc Injuries
Most cervical disc injuries are caused by hyperextension, which results in compression of the cervical area
Flexion injuries in the cervical area do not result in nerve compression.
Symptoms of Cervical Disc Injuries
The Pain may cause loss of sensation or tingling/pins and needles to the arms, and weakness are the main symptoms and signs of cervical disc injury. The pain is most noticeable symptom and it is usually the only one. Cervical disc injury can complicated by compression of either a cervical nerve root or by a compression of the spinal cord, but this reported injury is very infrequent. When compression of the nervous tissue occurs, patients may report different sensations other than pain. Weakness to the legs/leg this is called spinal cord compression. if the arms/arm are affected this is called nerve root compression
Pain can be felt in the neck or arm.
Pain is always in the area of the neck and upper back between the shoulder blades. This is due to inflammation of the disc and the cervical vertebra joints. Sever inflammation can flare up after a minor added injury or for other unknown reasons. Neck and shoulder pain are due to the disc bulges that herniates, and stretches the posterior longitudinal ligament.
b. Rarely, the pain will be felt down the arm. This pain can be lightning, caused or aggravated by movements of the neck, or can be dull and persistent. Pre-existing neck pain is also present in many individuals. After the arm pain starts, some people report feeling less pain in their neck. When arm pain is present, it is usually because of a combination of disc herniation and bony spurs compressing a nerve root. A free disc fragment can also intrude on a cervical root and cause quite a bit of pain in shoulder or down the arm.
2. Sensory symptoms other then pain.
When felt in only one arm, they are due to compression of a cervical root and felt in the territory of the cervical root. The C4 root mainly supplies the shoulder with nerves, while the C5 root supplies primarily the arm. The C6 root supplies nerves to the radial side of the forearm, the C7 root addresses the arm and forearm, and the C8 and the T1 root handle mostly the hand. Broadly speaking, two types of sensory symptoms are felt: loss of sensation and new sensations. A loss of sensation is simply numbness. New sensations include tingling (pins and needles), heat, or cold sensations.
If the spinal cord is compressed, most patients report losing sensation in their hand and in the lower part of their body. (Numbness) They have difficulty feeling the floor when they walk and cannot feel that their bladder is full or inconstancy this is an emergency and patients should be brought to the hospital right away.
3. Motor symptoms and signs.
Weakness of one arm (the other one being normal) only signals a compression of a nerve root. A compression of C4 results in a weak shoulder; C5 indicates a weak bicep muscle; C6 represents a weak wrist, thumb, and index finger; C7 is a weak tricep extension of the fingers, and pectoralis muscles; C8 designates weak flexion of the fingers; and T1 corresponds to a weak hand.
Emergency treatment.
If the spinal cord is compressed, patients report having difficulty walking and weak legs and hands, numbness these can be the only symptoms and should be treated as an emergency.
Although neck pain can be caused by injury, such as ‘whiplash’(WAD) injuries, it is often caused by the cumulative effect of improper sitting posture, reading in bed, poor work habits, stomach sleeping, lack of proper exercise and other lifestyle-related factors. All of these factors cause misalignments in the spine and eventually pain. In fact, the most important factor producing neck pain appears to be spinal misalignments. Even for people who complain that “stress” is causing their pain, the great majority of those have significant spinal misalignments that are contributing to their condition.
Uncorrected chronic spinal misalignments can eventually cause neck pain. As a spinal misalignment worsens, pressure can be put on delicate nerves, sending the surrounding neck muscles go into painful and movement-limiting spasm, headache, even numbness, tingling or weakness in the arms or hands
Neck pain as well as “whiplash” (WAD) injuries and both conditions can result in headaches and all three are commonly treated by Chiropractors.
The treatment is focused on the small joints in the back of the neck called facet joints that are responsible for neck pain. When these joints dysfunction but injury to the muscles he nerve fibres that innervate / act as sensors for these facet joints also serve to act as sensors to parts of the head. When these facet joints dysfunction these sensors become active, the brain cannot clearly differentiate between the facet joints and the mapping of the head and create the sensation of pain in a broader area- Headache.
Whiplash associated Disorder (WAD) common term “Whiplash’ (WAD)
FROM: Journal of Orthopaedic Medicine 1999; 21 (1): 22–25 university Department of Orthopaedic Surgery Bristol UK
Khan S, Cook J, Gargan M, Bannister G
Objective: To determine which patients with chronic Whiplash Associated Disorder (WAD) will benefit from chiropractic treatment.
Design: Retrospective review by structured telephone interviews of 93 consecutive patients seen in chiropractic clinic.
Setting: Independent chiropractic clinic in a large city.
Subjects: 93 patients, 68 female.
Main outcome measure: Gargan and Bannister grading pre and post treatment.
Results: Three groups of patients were recognised. Group 1 consisted of patients with isolated neck pain associated with a restricted range of neck movement. Group 2 consisted of patients with neurological symptoms or signs associated with a restricted range of movement. Group 3 comprised patients who described severe neck pain but all of whom had a full range of neck movement. Patients in this group often described an unusual group of symptoms, with a bizarre, non-dermatomal pain distribution. There was a significant difference in outcome between the three groups (p<0.001) with only groups 1 and 2 improving following chiropractic manipulation.
Conclusion: “Whiplash” (WAD) and Neck injuries are common. Chiropractic is the only proven effective treatment in chronic cases. Our study enables patients to be classified at initial assessment in order to target those patients who will benefit from such treatment.
Journal of Orthopaedic Medicine 1999; 21 (1): 22–2 university Department of Orthopaedic Surgery
