More than 1.7 million people in the US are affected annually by concussion, also known as mild traumatic brain injury (mTBI), and often concussion and cervicalgia headaches go hand in hand. Around 15% of people with concussion have symptoms that persist for three months or more, and sometimes patients don’t realize that neck and head pain are related to the earlier injury. This is especially true of people who have a minor bump or experience of whiplash on top of earlier head injuries. Read more
The majority of neck pain is caused by muscle strain and is typically resolved without medical intervention within a few days. However, pain in the front of the neck that persists, or which is severe and acute, can be a sign of a serious health issue that warrants medical attention. Read more
If you’re involved in a car crash and are overweight or obese then your risk of persistent neck pain is higher than for someone who is not overweight, according to a new study presented at the 63rd Annual Scientific Meeting of the American Pain Society (APS).
The results of this study showed that the risk of neck pain lasting at least six months after an accident almost doubles if the person is morbidly obese, so what is it that makes those who are overweight more vulnerable to chronic pain? Read more
A new study suggests that neck pain from whiplash may be relieved just as well by counselling on how to manage the condition as by physical therapy. The counselling was given in addition to a list of optional exercises and compared to an intensive physical therapy programme in the research carried out in Sydney, Australia. Read more
Older adults frequently experience neck pain and back pain, with a variety of anatomical, pathological, and physiological factors involved in the development of symptoms. Arthritis is a common cause of neck pain in seniors attributed to the spine itself, as are discogenic disorders, trauma, tumours, and infection. Other issues involve the muscles in the neck, or nervous system function. Below, we outline some key causes of neck pain, because knowing its origins is essential to getting appropriate treatments and, where possible, for preventing pain recurring. Read more
Tension neck syndrome is a pretty common condition that is caused by muscle strain in the upper back. The nature of repetitive work in cramped and uncomfortable postures common to the construction industry mean that tension neck syndrome is particularly prevalent amongst those doing manual labour.
The condition can result in neck stiffness, muscle spasms, and neck pain and/or pain radiating from the cervical spine to the shoulders, head, and even into the arms and chest. This condition is particularly common in those working in the construction industry, but there are ways to reduce the risk of tension neck syndrome in such jobs, with many of these solutions also applying in other areas of life. Read more
Ear, nose, and throat clinics are full of kids waiting to have their tonsils whipped out, but what about if you have a sore throat and neck pain as an adult? Does recurring throat and neck pain also necessitate surgery? If you’re suffering from chronic, severe, or recurring bouts of pain in the neck and throat then it’s time to see your physician and find out what’s going on. Read more
Many cases of whiplash and neck pain could be prevented by taking a few seconds to make some simple adjustments to your driving set-up. Don’t wait until you’ve experienced the pain of injury and have to research your whiplash treatment options before taking action. Adjust your seating position every time you get in the car if you share your vehicle with another driver and make sure to take the following safety tips into account when buying a new car. Read more
Researchers in the UK have concluded that active management consultations of whiplash in the emergency department are not cost effective and do not improve patients’ prognosis in acute whiplash, which can cause a number of symptoms, including neck pain. The types of things included in active management for acute whiplash were intensive physiotherapy, promotion of positivity for recovery, exercise, early re-engagement in daily routines, an educational booklet on whiplash, and pain management assistance. Patients receiving this type of care, compared to standard care, saw little additional benefit and no long-term benefits leading the authors to conclude that ‘less is more’ when it comes to acute whiplash care.
Usual Care vs. Active Whiplash Management
The study was published in the Lancet’s February 16th edition and was carried out by Sarah E. Lamb, DPhil, and colleagues from the Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom. A two-step process was rolled out for patients visiting one of 12 hospitals or 15 emergency departments (EDs) taking part in the study. Six of the hospitals and seven of the EDs recruited patients for the active management protocol and the remainder proceeded with usual consultation practices. The data was adjusted for initial whiplash grade and other potential confounding factors.
Symptoms of Whiplash Associated Disorder
Whiplash can cause a number of ongoing problems years after the initial injury and many of these are difficult to connect to the neck trauma, leading to problems in applying proper treatment. There is some evidence that cervical spine instability is more common in those suffering whiplash, with conditions such as facet joint arthritis and tinnitus an increased risk for such patients. Whiplash associated disorder may also involve cognitive deficits that can take weeks, months or even years to resolve, if at all. Headaches and neck pain are commonly associated with whiplash associated disorder and patients are often advised to do their best to avoid unnecessary stress and strain on the neck.
Little Difference with Added Care
Some 3851 patients took part in the first stage of the study, 2253 of whom were seen in hospitals in the active management group and 1598 in the hospitals providing usual care. Just over half of the acute whiplash patients were women (55%) and the mean average age was 37 years. Follow-up data was available for 70% of patients at the 12 month mark and the results showed little difference between the groups. The median Neck Disability Index scores varied by 0.5; a difference of 3 points is considered clinically meaningful.
Is Additional Physiotherapy Helpful in Whiplash?
In step two of the study, half of the patients were given a single physiotherapy session, to consolidate the advice given in their earlier ED visit, and the other half had a series of six physiotherapy sessions. Two thirds (67%) of the patients in the active group completed the prescribed course of physio after whiplash and 80% of the usual care group finished the course; those who provided follow-up data at four months (80%) showed modest benefit for neck disability but there was no long-lasting benefit at eight or twelve months. The additional cost of these sessions and the lack of clear benefit led the researchers to conclude that a single session and usual care in the hospital or emergency department is the recommended treatment for acute whiplash.
Lamb, S.E., et al, Lancet. 2013;381:514-515, 546-556.
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