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Whiplash Injury
Ross Hauser, M.D.
The term "whiplash" describes an injury of sudden hyperextension followed by
hyperflexion of the neck. When no objective signs of damage to the
cervical
spine are found on radiography and no clinical signs of nerve root damage
appear, the injury is termed whiplash injury or neck sprain injury. A
significant proportion of the patients have long-lasting symptoms, disabling
some of them for long periods of time.
In whiplash injuries,
headache or
neck pain often does not come on immediately.
It can build over several weeks, to become horrible several weeks after the
injury. The injury may not have even been considered significant at the time it
occurred.
The most common symptoms after whiplash injury are neck pain, neck stiffness,
headache,
shoulder pain,
back pain, and difficulties with concentration and
memory. Dizziness, buzzing in the ears, insomnia, depression, and anxiety are
also reported.
To accurately diagnose the cause of neck or head pain, a listening ear and a
doctor's strong thumb (for palpatory examination-to press on and isolate the
pain causing area) are generally all that is needed. Diagnostic tests, such as
x-rays, CAT and
MRI scans cannot diagnose the source of pain. As a matter of
fact, they often lead the patient and physician astray.
MRIs Can Lead You Astray
In a large study published in 1998 at The Keio University School of Medicine,
497 people with absolutely no neck or head pain or injury were given MRI scans
of their necks. The results were as follows:
In those people in their 20s: Seventeen percent of the men and 12 percent of the
women had abnormalities of
disc degeneration.
In those people in their 60s: This percentage climbed dramatically as 89 percent
of men and 86 percent of women had evidence of
disc degeneration. (Matsumoto, M.
et. al. MRI of cervical intervertebral discs in asymptomatic subjects. The
Journal of Bone and Joint Surgery. 1998; 80B:19-24.)
This study just tells you how misleading MRI scans can be. Approximately 90
percent of people over 60 years of age supposedly exhibited
arthritis in the
neck, but they were totally asymptomatic. This does not require a surgical
consult. Guess what would happen if the people had neck pain in addition to
these findings on MRI? They would get surgical consults, possibly ending up with
surgery because of the disc degeneration and arthritis.
Prolotherapy as a Treatment for Head and Neck Pain
The areas to be treated with
Prolotherapy are determined by palpatory
examination of the posterior head and neck. Again, the accuracy in diagnosing
the actual pain-producing area is excellent, because the physician recreates the
patient's pain by palpating the neck and posterior head carefully until a
positive jump sign is elicited. This gives the patient and the physician
confidence that the pain-producing structure is between the physician's thumb
and the underlying bone. The structures that are typically involved are the
cervical vertebral ligaments. These tender areas are treated with
Prolotherapy injections. Typical areas treated during
Prolotherapy sessions for
chronic headaches and neck pain are the base of the skull, cervical vertebral ligaments,
posterior-lateral clavicle, where the trapezius muscle attaches, as well as the
attachments of the levator scapulae muscles. Because there is an anesthetic in
the solution, generally the neck or headache pain is immediately relieved. This
again, confirms the diagnosis both for the patient and the physician.
Dr. Hackett reported good to excellent results in 90 percent of 82 consecutive
patients with neck and/or head pain whom he treated with Prolotherapy. (Hackett,
G. Prolotherapy for headache. Headache. 1962; 1:3-11. / Hackett, G. Prolotherapy
in whiplash and
low back pain. Postgraduate Medicine. 1960; pp. 214-219.)
Dr. Kayfetz and associates treated 206 patients who had headaches caused from
trauma. They found that Prolotherapy was effective in completely relieving the
headaches in 79 percent of patients. (Kayfetz, D. Whiplash injury and other
ligamentous headache-its management with Prolotherapy. Headache. 1963; 3:1-8.)
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