Scientists predict whiplash injury chronic pain using MRI

By: Dr. Victor Marchione | Pain Management | Tuesday, January 12, 2016 - 02:38 PM

Scientists predict whiplash injury chronic pain using MRI

In what is being seen as a significant development, clinicians can now predict chronic pain after whiplash injury with the help of MRI plates.

Whiplash is a neck injury that is commonly caused by a sudden movement of the head forwards, backwards or sideways. It commonly happens after a sudden impact such as a road traffic accident. The vigorous movement of the head because of inertia of motion overstretches and damages the tendons and ligaments in the neck.


Common symptoms of whiplash include:

  • headaches
  • neck pain and stiffness
  • reduced and painful neck movements
  • tenderness over the neck muscles

Usually the symptoms of whiplash manifest anywhere between six to 12 hours after the time of accident.

The neck pain and stiffness is often worse on the day after the injury and may get worse for several days afterwards. Whiplash from motor vehicle collisions affect more than 4 million Americans annually. It harms their quality of life and the costs for treating and rehabilitating whiplash related injuries is currently estimated at $30 billion annually.

Previously scientists and clinicians were not able to predict who will develop chronic pain and who will not, but that is about to change thanks to recent developments.

Scientists identify within 1-2 weeks of injury who will develop chronic pain

chronic pain after whiplash injury

While most people fully recover from whiplash injuries within the first 4-8 weeks, about a quarter of the patients develop pain and disability that lasts many months, even years.

Using special MRI imaging, Northwestern Medicine scientists have been able to pinpoint which whiplash injury patients will go on to develop chronic pain, disability and post- traumatic stress disorder (PTSD). And they could do this within the first fourteen days from the date of the injury. According to the scientists, this is a real breakthrough, as chronic pain development has never been diagnosed this early in a whiplash patient’s post injury cycle.

It is understood that this ability to identify chronic pain development so early in the patients will enable faster and more specialized treatment, which could be particularly beneficial for the PTSD.

Using a sophisticated MRI that measures the fat/water ratio in the muscles, scientists found that in the patients in the chronic pain group there were unusual muscular changes. The scientist noticed that there was a large amount of fat seeping into the patients’ neck muscles. This kind of a fatty infiltration could lead to rapid atrophy of the muscles.  The researchers also noted that the presence of the infiltrated fat is not related to the patient’s body size or shape.

The team believes these findings clearly indicate that the injury is more severe than a typical low-speed car crash. According to the lead investigator of the study, James Elliott, assistant professor of physical therapy and human movement sciences at Northwestern University Feinberg school of Medicine, their findings opens up a new door for research on whiplash. Until now, whiplash has been treated as a homogenous condition. But this study clearly shows that whiplash patients are not all the same. They have different clinical signs and symptoms and as such, should be treated differently.

Thanks to this study, clinicians will now be in a better position to…

Prevent chronic pain after whiplash injuries

Scientists predict whiplash injury chronic pain using MRIAfter sustaining whiplash injuries, it is common for people to suffer from chronic neck pain. A basic chiropractic examination can detect certain factors in a patient’s history and it will help the clinician to better determine how to treat whiplash symptoms and find out which patients may be more susceptible to chronic pain from a whiplash injury.

This process will help the chiropractor identify when aggressive preventative measures should be taken for patients who may be at a greater risk of developing chronic neck pain from whiplash injuries.

The chiropractor’s general approach to managing the patient’s chiropractic care is critical to the success of preventing chronic pain from whiplash injuries.

In the early stages of management, the chiropractor top priority is to rapidly reduce the patient’s neck pain and other body pains.

The next step is to focus on the restoration of the patient’s function. This includes helping the patient return to his daily activities as soon as possible after sustaining the whiplash injuries. This process may involve a gradual transition to these activities, even if the patient is not sure that he or she can engage in them fully.

Restoring the patient’s confidence after a whiplash injury is critical, as it will play a role in the patient getting back to normal activity levels.

The last step is to give the patient an exercise regimen that will help the patient correct faulty movement and instability, and improve general fitness.

Diagnosis and treatment for whiplash injuries

Thanks to the current study, it is now easy to diagnose which patients will develop chronic pain (see above) so let us take a close look at how to alleviate the symptoms of whiplash injuries.

Applying an ice pack immediately after the injury occurs, or as soon as possible, helps reduce swelling and inflammation. If an icepack is not available, wrap the ice in a towel and apply to the affected area for about 10 – 30 minutes.

In the days following the injury, patients should try to move their necks normally. The neck should be moved slowly in each direction, gradually widening the range.

Of course, in cases where symptoms are severe, the individual may have to completely rest the neck until the pain allows for movement.

If the pain is too unbearable, painkillers, such as Tylenol should help reduce whiplash injury pain. While some doctors may advise patients to take painkillers regularly, it is not advisable as they can irritate the stomach lining and cause other problems

It is also important that post the injury, the patient maintains an upright good posture –  keep the back straight when walking, standing or sitting. While sleeping, a firm pillow can help maintain good posture.

As you can see, whiplash injury can become chronic and the symptoms can last for years. Therefore, it is crucial that you take the necessary precautions to prevent being injured. One way to do this is to make sure the headrest in your car is adjusted correctly so that your head is prevented from moving backwards.


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Related Reading:

Dry eye linked to chronic pain syndrome

Depression, anxiety, mental disorders in teens increases chronic pain risk

Sources:

http://www.nhs.uk/conditions/whiplash/Pages/Introduction.aspx
http://www.medicalnewstoday.com/articles/174605.php
http://www.spine-health.com/treatment/chiropractic/preventing-chronic-pain-whiplash
http://www.medicalnewstoday.com/articles/174605.php?pa

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