When pain occurs it is showing you that somewhere in your body a problem has surfaced.  People shrug pain off everyday thinking it will work its way out, but that may not be the case.  You might need to seek professional help to correct and maintain the problem.

There are two types of pain:

1.  Acute Pain- This pain is new to the body and can be caused by a sprain, cut, broken bone etc. The pain can be mild to severe and will usually dissipate with healing.

2.  Chronic Pain- This pain is different and might be accompanied by insomnia, exhaustion, even weight change and can last up to six months or more.  Many look to painkillers to alienate the symptoms, this seems like the right thing to do, after all no one wants to live in the discomfort of pain.  Quite often painkillers will mask the cause of the problem by reducing the amount of pain.  Doesn’t it make more sense to find the true cause of the pain and treat it directly?

This article is a case report of 46-year old patient with a whiplash-associated disorder following a rear-end bumper car collision. The patient suffered with debilitating neck pain and headaches for eight years after this low-velocity collision.

The patient stated that he was not prepared for the impact. His headaches and neck pain developed immediately after the accident and did not improve over subsequent weeks. With a year he was worse and largely disabled. He had never sustained any kind of acute neck trauma before or after this bumper car episode.

X-rays of the cervical spine and left shoulder, MRI of the neck, CT scan of the neck and electromyography, did not identify a cause for the unremitting symptoms.

The x-rays were also negative for evidence of acute injury and showed no degenerative or other chronic changes that could be associated with his headaches or neck pain.

On physical examination, the patient demonstrated limitations in neck mobility with focal tenderness at the posterior cervicothoracic junction. Palpation of several trigger points in that area caused radiating pain along the neck and into the right shoulder. There were no motor, sensory, or deep tendon reflex deficits in either the upper or lower extremities, and there was no clinical evidence of a peripheral compression neuropathy. Yet, the patient developed diffuse paresthesias in the right and left hands and forearms.  His writing hand had weakness and poor coordination.

After 8 years, the fascia was surgically resected where small sensory nerves and vessels perforated the structures, resulting in decompression.  They did not remove muscle tissue. This surgical treatment resulted in an increase in cervical range of motion by 20%, reduced intake of pain medication, doubled the number of work hours, and generally led to a dramatic improvement in quality of life.

The authors cite two studies that concluded that “rear-end collisions with a delta V of 10-15 km/h [6.2-9.3 m/h] or less cannot result in whiplash associated disorder,” and then cite 3 other studies that disagree with the conclusions of those studies.  The authors conclude that “there is no consensus regarding a threshold value for the delta V that can precipitate WAD after low-velocity, rear-end collisions.”

These authors cite a 1997 study that showed cervical range of motion measurements obtained at 3 months serve as valid predictors of permanent disability after a whiplash trauma. Another study notes that cervical range of motion can discriminate between asymptomatic patients and patients with persistent symptoms after whiplash trauma, concluding that such measurements are reliable parameters of physical impairment from whiplash injury.

These authors note:

                    1)  “Imaging studies, including MRI, is not sufficient to exclude significant injury after whiplash trauma to the neck.”

                    2)  “A variety of factors, including the occupant’s awareness or head position in a colliding vehicle, defines the risk of neck injury to passengers in colliding vehicles.”

                    3)  “One can only conclude that the threshold of injury is a complex dynamic relying on velocity, force, head position, head-torso angles, restraint placement, anticipation, tissue elasticity, tissue strength, and any multitude of variables that evade accurate determination.”

                    4)  “The risk of permanent symptoms may be minimal after low-velocity collisions, yet research cannot disregard the clinical possibility of injury based on small studies that fail to simultaneously consider all pertinent variables.”

                    5)  Soft-tissue damage is a more likely cause of chronic whiplash in patients when there are negative imaging studies.

                    6)  “Considering the complex mechanism of trauma, a common pathophysiology is not likely among all individuals with whiplash associated disorders, and their condition must therefore be assessed individually in light of the clinical syndrome and the objective findings.”

                    7)  “This case history illustrates that a low-velocity collision can cause soft-tissue damage in the posterior neck, which may lead to chronic symptoms consistent with whiplash associated disorders.”

8)                 “The myriad of dynamic variables between occupant and vehicle precludes a definition of change-in-velocity thresholds for neck injury from car collisions.”

                    9)  “Computerized motion analysis is a reliable method to confirm whiplash-associated disorder, quantify the patient’s physical impairment, and identify indications for surgical treatment.”

Key points from this article are:

                    1)  There is no consensus as to the threshold of force required to injure a patient or to cause permanent injury from motor vehicle collisions.

                    2)  Cervical range of motion analysis is important in confirming the diagnosis of whiplash-associated disorder and in the evaluation of prognosis and treatment and permanent disability.

                    3)  The studies that conclude one cannot be injured with delta Vs of less than 15 km/h (9.3 m/h) are wrong.

                    4)  Cervical range of motion measurements obtained at 3 months is a valid predictor of permanent disability after a whiplash trauma.

                    5)  Cervical range of motion can discriminate between asymptomatic patients and patients with persistent symptoms after whiplash trauma.

                    6)  Cervical range of motion measurements is a reliable parameters of physical impairment from WAD.

                    7)  Normal x-rays, MRI, CT, and EMG studies do not mean that one is not injured or impaired or suffering from debilitating chronic symptoms.

                    8)  One can suffer from diffuse extremity paresthesias, motor weakness and poor coordination without a radiculopathy.

                    9)  One can suffer from diffuse extremity paresthesias, motor weakness and poor coordination with normal motor, sensory, and deep tendon reflex examinations.

                    10)  Imaging studies, including MRI, do not exclude significant injury after whiplash trauma to the neck.

                    11)  An occupant’s awareness and/or head position are important factors is assessing the risk of neck injury to passengers in colliding vehicles.

                    12)  Whiplash threshold of injury is a complex dynamic relying on velocity, force, head position, head-torso angles, restraint placement, anticipation, tissue elasticity, tissue strength, and any multitude of variables that evade accurate determination.

                    13)  If imaging studies are negative, the cause of chronic whiplash symptoms is probably soft tissue injury.

                    14)  A low-velocity collision can cause soft-tissue damage in the posterior neck, which may lead to chronic whiplash symptoms.

                    15)  Between the occupant and the vehicle there are so many variables, it is impossible to establish a change-in-velocity thresholds for neck injury from car collisions.ic can be your answer to a better lifestyle.