Anyone who has treated patients with whiplash knows that the pain associated with whiplash is somehow different from other types of neck pain. Of the hundreds of patients I have treated who have suffered whiplash, a disproportionate number seem to develop chronic Inside Clinical Massage, unremitting pain.
Another characteristic of whiplash is that the initial pain associated with a neck injury often spreads to nearby regions of the shoulders, arms, or even the mid-back. Unfortunately, for many whiplash patients, the pain all too often spreads throughout the body, leading to a condition known as chronic widespread pain syndrome.
Because whiplash injuries often result in litigation, many physicians and especially defense attorneys attribute this chronic, non-remitting pain associated with whiplash to the fact that patients often seek financial gain through litigation.
In my own practice, I have seen patients who continue to suffer from neck and other pain for many years after the conclusion of their litigation and the payment of compensation. This observation argues against litigation being the reason that people so often develop long-term and widespread pain after whiplash.
There is growing evidence in the scientific literature that whiplash is a unique type of injury and that a significant number of people who have suffered this type of injury later develop long-lasting pain that spreads far beyond the original neck injury.
Researchers, publishing in the medical journal Pain, studied nearly 1,000 patients who had been involved in a car accident and suffered whiplash. They compared the patients who were involved in a lawsuit to patients with whiplash who were not involved in a lawsuit. The authors of this study concluded that persistent pain after a motor vehicle accident is common even in patients who are not involved in litigation.
Their findings suggest that a physiological abnormality is likely responsible for the frequent occurrence of persistent, widespread pain after whiplash that is not related to litigation.
Other researchers, published in the journal Disability Rehabilitation, studied more than 700 patients with post-traumatic neck pain. They found that nearly twice as many female as male whiplash victims reported chronic widespread pain. They conclude that the high incidence of regional and widespread pain in patients with persistent neck pain after trauma requires a multidisciplinary treatment approach.
These findings suggest that conventional treatments for whiplash often fail to address the underlying problem and put a significant number of patients, particularly women, at risk of developing chronic widespread pain symptoms.
The significant number of patients who develop chronic pain symptoms after whiplash, often spreading to adjacent body regions or the entire body itself, suggests that whiplash affects more than just the muscles and joints of the neck itself. It even suggests that brain function may be altered in patients who develop long-lasting and widespread pain after whiplash.
To explain how altered brain function can lead to chronic and widespread pain, we need to look at the neurological circuits that normally process pain and injury.
Think about the last time you stubbed your toe. The initial intense pain quickly turns into a series of more painful and less intense symptoms. This is because at the moment of initial impact, certain circuits are activated to tell the brain that the body has been injured. The circuits rise from the periphery, in our example the toe, up the spinal cord to the brain itself. When the signal reaches the brain, you become aware that you have injured your toe. But that's not the end of the story. Shortly after you become aware that you have injured your toe, another neurological circuit is activated. This circuit leads from the brain back to the spinal cord and is tasked with dampening or shutting down the pain signals that are rising up.
This is a simplified example that explains why the intense pain of stubbing your toe soon turns into an aching, throbbing sensation that is unpleasant but quite different from the original painful experience.
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