Whiplash & Neck Injurys
Neck pain affects a huge number of people and comes about for a range of reasons. These include:
An injury such as a car accident or a sports related incident such as a ‘stinger’
Degenerative change (osteoarthritis)
A pathological condition
Spinal stenosis (narrowing)
Insidious onset when there is no obvious reason or start point.
The last situation accounts for a huge number of people that we see and the pain is usually impacted upon or caused by several factors including posture, stress & general tissue health. Once the cycle of sensitivity begins, the symptoms can become pronounced to the point that the pain affects concentration, memory and mood. In most cases there is nothing serious underlying the pain, however normal activities such as sitting, lifting and carrying can hurt as the body (brain) seeks to protect the tissues.
Symptoms that can occur in relation to the neck include:
Tenderness on palpating muscles of the neck, shoulders & upper back
Referred pain into the arms & hands (pain, pins & needles, numbness)
Increased sense of hand/finger size
Ear: muffled, pain, like water is in the ear
Head & facial symptoms
Whiplash (Associated Disorder) WAS
Often sustained during a road traffic accident (RTA), whiplash injuries are also noted during sports activities and other occasions when the head and neck are forcibly extended and flexed. Clearly this can result in damaged tissue and it is important to rule out serious injuries. Fortunately in most cases it is the soft tissues that are injured. However, we now understand far more about the body’s response to an accident that goes far beyond ligament or muscular damage. This is good news as we can explain the range of symptoms described by sufferers, providing reassurance and reducing the anxiety that often accompanies the situation.
We know that even with minor tissue damage following an accident there can be significant pain, stiffness and other symptoms. This is because an RTA is inherently a stressful and unpleasant experience that triggers a body wide response to protect us and allow healing to take place. The pain is often amplified by the fact that the nervous system becomes sensitised and is on alert for further danger. A branch of the nervous system called the autonomic nervous system is activated and is responsible for changes in blood flow, increases in heart rate, sweaty palms, visual changes, feelings of panic and anxiety and bowel disturbances (vomiting and diarrhoea). Essentially these are all protective measures to promote survival. Unfortunately in many cases these symptoms can persist and are indeed worrying. Simply knowing that there are a range of feelings and responses can help to calm the system and make you feel better. In addition the immune system is called into play, releasing chemicals that give us the experience of feeling generally unwell. This is the same response as when we have the flu and it feels similar. You may feel achy, tired, easily reach fatigue, lose your appetite, feel unwell, experience disturbed sleep, feel low in mood, find it difficult to focus, learn and concentrate. Essentially we want to rest and retire from our normal lives for a while to recuperate and actually this can and should form part of the early treatment programme.
Some people experience flashbacks and nightmares and although in the early days this is understandable, repeated episodes can slow the rehabilitation process. This being the case you will be advised to discuss this with your GP and be referred to a psychologist who helps you to resolve this aspect of the problem. Any activity or thought that causes stress will potentially amplify the pain. Thinking about the accident or seeing someone move their neck quickly can be enough to provoke further pain as your brain can deem there to be a threat by watching another person move or by ‘replaying’ what happened in the accident.
In the early stages we seek to relieve the pain with medication and gentle movement. As you become more confident, less anxious about movement and the pain improves you will be more willing to move. The duration of the symptoms varies enormously with some people feeling better as soon as a few weeks after the accident. In most cases there is gradual improvement over 3-6 months with treatment and effective self-management strategies.
At Specialist Pain Physio we understand the underlying processes of whiplash and can offer treatment and advice that will lead you to a resolution and return to activities.
Common symptoms of whiplash associated disorder include:
Neck pain & stiffness
Tender muscles & skin
Sensitivity to light touch & brushing
Altered sensation in the upper limbs, neck & upper back (pins & needles, numbness)
Referred pain in the arms & hands
General malaise (feeling under the weather, flu-like symptoms include aching, loss of appetite, desire to rest, disturbed sleep, fatigue, low mood, poor concentration, ‘foggy’ brain, memory loss)
Feelings of anxiety & panic disorder
Disturbed bowel function
Nausea & vomiting
Widespread aches & pains
Flashbacks & nightmares