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What condition is causing my neck pain?

There are many conditions that can cause chronic neck pain. The following information describes symptoms of some of the more common causes of chronic neck pain.

Neck Pain That Radiates Down the Arm

Pain that radiates down the arm, and possibly into the hands and fingers, is frequently caused by a cervical herniated disc or foraminal stenosis pinching a nerve in the neck.

The pain may be accompanied by numbness or tingling in the arms and/or hands. The symptoms may start suddenly or develop over time.

The approach to treatment for a cervical disc herniation is guided by how long the pain lasts, pain intensity and the degree to which the cervical nerve and/or spinal cord are affected.

Most commonly, the symptoms are temporary and can be treated successfully with nonsurgical care (such as medication, physical therapy, manipulations).

If the pain does not respond within 6 to 12 weeks of conservative treatments, then surgery may be recommended.

Neck Pain That Is Related to Certain Activities or Positions

Neck pain that develops slowly (often over a number of years) and tends to occur during or after certain activities or neck positions is frequently caused by cervical foraminal stenosis. Usually, impingement of one nerve root on one side of the spine causes most of the symptoms.

This type of spinal stenosis is caused by wear or aging related changes in the joints of the neck (facet joints) or at the margins of the discs. These changes may be diagnosed by either an MRI or a CT scan with a myelogram.

As with a herniated disc, the mainstay of treatment for stenosis is medical care (medicine, therapy, exercise, injections, etc.).

If the pain is severe or prolonged, or the functional impairment is sufficient, surgery may be recommended to open up the disc space and give the nerve root more room.

Cervical Radiculopathy

Arm Pain with Lack of Coordination

Pain that radiates down the arm, along with symptoms such as lack of coordination in the arms and legs, difficulty with fine motor skills, and occasional intermittent shooting pains, is commonly caused by cervical spinal stenosis with myelopathy.

These symptoms, which are caused by either a cervical herniated disc or degenerative changes in the joints that can cause pressure on the spinal cord, generally develop slowly.

Symptoms may not progress for years, and then the patient may notice progression of the coordination difficulties, only to be followed by another long period where there is no progression.

Conservative treatments may help relieve the chronic arm pain, but the definitive treatment option for the spinal cord compression (which causes the coordination difficulties) is surgery to decompress the spinal canal.

Neck Pain That Persists for More Than a Few Months and May Fluctuate

Neck pain that is often characterized by a low level of chronic pain that sometimes “flares” and gets worse, is made worse by certain positions or activities, and may be accompanied by arm pain, may indicate symptomatic cervical disc degeneration.

While cervical disc degeneration is virtually ubiquitous in humans, symptoms from this “gray hair of the spine” are less common and often short-lived.

However, there may be an event, such as a twisting injury to the disc space, which precipitates the onset of symptoms and, in a subset of such people, may lead to chronic neck pain. Such symptoms are often proportional to the person’s level of activity; that is, the more the shoulders, arms and neck are used, the more they hurt.

Neck Pain That Is Worse in the Morning and at the End of the Day

Paradoxically, there are also patients who feel their worst when they first rise in the morning and at the end of the day. These people often feel best when they are moving their neck, and they often prefer warm, sunny days to cool, rainy or overcast days.

Such symptoms parallel those experienced by patients with osteoarthritis of the weight-bearing joints (e.g., hips and knees). It is presumed that arthritic changes in the facet joints play a role in these people.

Degeneration in the cartilage of the facet joints can produce pain and tends to occur in older adults (over 60 years old).

The facet joints are designed to move against smooth surfaces, but as the cartilage degenerates it develops a lot of friction and there is accompanied loss of motion. Often the chronic pain is worst first thing in the morning.

Range of motion exercises, physical therapy, traction, and manipulations can all help preserve motion and lessen chronic pain.

In addition to the above conditions, there are a number of other less common cervical conditions. These cervical conditions can cause shoulder pain, wrist pain, elbow pain, or headaches.

Rule out the Causes, Prevention and Treatment for your Neck Pain today. Treat Neck Pain without Surgery. Call us at +65 64712744 or SMS to +65 92357641 (24Hrs) for Appointment.

Cervical Radiculopathy (Pinched Nerve)

Are you suffering from Neck Pain / Cervical Radiculopathy that is not getting better? You are at the right place. Cure your Neck Pain today. Singapore Neck Pain Specialist Centre. Call +65 64712744 or SMS to +65 92357641 to schedule for an appointment today.

Some people have neck pain that may radiate into the shoulder and arm. This type of pain is often caused by an injury near the root of a spinal nerve. A nerve root injury is sometimes referred to as a “pinched” nerve. The medical term for this condition is cervical radiculopathy.

Understanding your spine and how it works can help you better understand cervical radiculopathy.

Causes of Cervical Radiculopathy (Pinched Nerve):

As the disks lose height, the vertebrae move closer together. The body sees the collapsed disk as a possible weak area and responds by forming more bone called spurs around the disk to strengthen it. The bone spurs that form also contribute to the stiffening of the spine. Bone spurs may also narrow the area of the forearm and pinch the nerve root.

The disk changes that occur with age are often called arthritis or spondylosis. It is important to keep in mind that all these changes are “normal” and they occur in everyone. In fact, if MRI scans were performed on all people aged 50 or older, nearly half of the scans would show worn disks and pinched nerves that do not cause painful symptoms. It is not known why some patients have symptoms and others do not.

Symptoms of Cervical Radiculopathy(Pinched Nerve):

Cervical radiculopathy pain travels down the arm in the area of the involved nerve. Pain is usually described as sharp. There can also be a “pins and needles” sensation or even complete numbness. In addition, there may be a feeling of weakness with certain activities.

Symptoms can be worsened with certain movements, like extending or straining the neck or turning the head. These symptoms are often made better by placing the hand on the head and stretching the shoulder.

Radiologic Investigation of Cervical Radiculopathy(Pinched Nerve):

X-rays

X-rays can show the alignment of bones along the neck. They can also show any narrowing of the foramen and disks.

Computed tomography (CT)

CT scans show the bones of the neck in finer detail. Bone spurs can be seen with CT, especially spurs near the foramen.

Magnetic resonance images (MRI)

An MRI of the neck can show if nerve compression is caused by soft tissue, such as a bulging disk and herniations. MRI can also show the appearance of the spinal cord and nerve roots.

Electromyelography

Electromyography and nerve conduction studies may be able to help show the difference between symptoms caused by pressure on spinal nerve roots and nerve damage caused by other ailments, such as diabetes.

Treatment of Cervical Radiculopathy (Pinched Nerve):

It is most important to note that the majority of patients with cervical radiculopathy get better with time and never need surgery, or even any treatment at all.

Some patients will have the pain go away quickly over days to weeks, while others take longer. It is also not uncommon for cervical radiculopathy to come back at some time in the future, but again, this problem usually gets better without any specific treatment. Some patients do develop persistent symptoms and require evaluation and treatment for the arm pain or weakness.

Nonsurgical Treatment

If you are not getting better, your surgeon will recommend a course of treatment. Treatment for radiculopathy starts with nonsurgical options.

Soft Collars. Soft collars allow the muscles of the neck to rest and limit neck motion. This can help decrease pinching of nerve roots with movement. Soft collars should only be worn for short periods of time, because long-term wear can decrease the strength of neck muscles.

Physical Therapy. Physical therapy can help with neck muscle stretching and strengthening. Sometimes, traction is also used.

Medications.

  • Nonsteroidal anti-inflammatories (NSAIDS). These include drugs like aspirin and ibuprofen, and may be helpful if the arm symptoms are from nerve swelling..
  • Spinal injections. Sometimes, an injection of steroids can be placed near where the nerve is being pinched. This takes advantage of the anti-inflammatory effects similar to oral steroids. The injection may be placed between the laminae (epidural steroid injection), in the foramen (selective nerve injection), or into the facet joint.While steroid injections do not take the pressure caused by a narrow foramen or herniated disk off the nerve, they may lessen the swelling and relieve the pain enough to allow the nerve to recover with more time.

Surgical Treatment

There are several surgical procedures for radiculopathy. The procedure that is right for you will depend on many factors, most importantly the type of problem you have.

CURE YOUR NECK PAIN TODAY! CALL +65 6471 2744 or SMS to +65 92357641 FOR APPOINTMENT

Common Cycling Injuries

Since the 1800s when bicycles first made their appearance, cycling has become popular for commuting, recreation, exercise, and sport. Studies estimate that large numbers of these cyclists experience physical problems: 48 percent in their necks, 42 percent in their knees, 36 percent in the groin and buttocks, 31 percent in their hands, and 30 percent in the back. No matter why they use a bicycle, young people can follow some basic safety principles to avoid common cycling injuries.

WHAT ARE THE MOST COMMON CYCLING INJURIES AND HOW CAN THEY BE PREVENTED?

Knee Pain

The knee is the most common site for overuse injuries in cycling. Patellofemoral syndrome (cyclist’s knee), patella and quandriceps tendinitis, medial plica syndrome, and iliotibial band friction syndrome are a few of the more common knee overuse injuries. The first four injuries mentioned involve pain around the kneecap, while the last condition results in outer knee pain. Shoe implants, wedges beneath the shoes, and cleat positions may help prevent some overuse injuries.

Head Injuries

One of the most common injuries suffered by cyclists is a head injury, which can be anything from a cut on the cheek to traumatic brain injury. Wearing a helmet may reduce the risk for head injury by 85 percent. The majority of states have no laws governing the use of helmets while riding a bicycle, but helmets are readily available for purchase and typically low in cost.

Neck/Back Pain

Cyclists most likely experience pain in the neck when they stay in one riding position for too long. An easy way to avoid this pain is by doing shoulder shrugs and neck stretches that help relieve neck tension. Improper form also leads to injuries. If the handlebars are too low, cyclists may have to round their backs, thus putting strain on the neck and back. Tight hamstrings and/or hip flexor muscles can also cause cyclists to round or arch the back, which causes the neck to hyperextend. Stretching these muscles on a regular basis will create flexibility and make it easier to maintain proper form. Changing the grip on the handlebars takes the stress off of over-used muscles and redistributes pressure to different nerves.

Wrist/Forearm Pain or Numbness

Cyclists should ride with their elbows slightly bent (never with their arms locked or straight). When they hit bumps in the road, bent elbows will act as shock absorbers. This is also where changing hand positions will help reduce pain or numbness. Two common wrist overuse injuries, Cyclist’s Palsy and Carpal Tunnel Syndrome, can be prevented by alternating the pressure from the inside to the outsides of the palms and making sure wrists do not drop below the handlebars. In addition, padded gloves and stretching the hands and wrists before riding will help.

Urogenital Problems

One common complaint from male riders who spend a lot of time riding is pudendal neuropathy, a numbness or pain in the genital or rectal area. It is typically caused by compression of the blood supply to the genital region. A wider seat, one with padding, a seat with part of the seat removed, changing the tilt of the seat, or using padded cycling shorts will all help relieve pressure.

Foot Numbness and Tingling

Foot numbness and tingling are common complaints, and shoes that are too tight or narrow are often the cause. In addition, foot numbness can be due to exertional compartment syndrome. This arises from increased pressure in the lower leg and resulting compression of nerves. The diagnosis is made by pressure measurements and is treated with surgical release.

Get professional consultation and treatment about your Cycling Injury. Call +65 6471 2744 or SMS to +65 9235 7641 for Appointment

Neck Pain after Long Hours in Computer

Did you know that spending long hours at your computer can put your health at serious risk? Most people does not even consider that possibility, but t does, Working at a desk is extremely hard on your body, and I would like to share this with you so maybe you can avoid some of the most common health risks. One of the most common one is: NECK PAIN

Tips for NECK PAIN relief

Neck pain can really get irritating if it persists for long periods of time. The pain can get unbearable that’s why some people succumb to taking medications or pain relievers only to find out that they don’t do them any good. Let’s check out these simple and basic tips on how to treat and relieve you from neck pain.

1. Get spinal checkups regularly. It is very important to always keep your spine aligned. This can ensure the proper functioning of your neck and back, specifically the upper region. Physiotherapy will do spinal adjustments on you. This can decrease the stress on your thoracic and cervical spines. It also improves the communication between your brain and all parts of the body. As a result, a happier and healthier you.

2. Always be conscious of your posture. There are a lot of people who exhibit poor posture. When asked to stand up straight, they are unable to exude the proper posture anymore. This is because they have been used to that kind of posture and they are unaware of it already. Proper posture does not only involve the back, as lot may think. It also includes the neck. Poor posture, if not dealt with can give rise to neck pain as well.

3. Exercise regularly. Exercising does not only do good to the body’s muscular and cardiovascular system but to the skeletal system, too. For an efficient and effective program, you have to do at least three sessions a week for about forty minutes. In order to be more inspired to do these exercises, involve the whole family and your friends. It will benefit, not only yourself, but your loved ones as well.

4. Eat well and eat right. Naturally, you keep your body healthy by eating the right food at the right amount. When you observe proper diet and nutrition, your body will the given the appropriate energy or fuel that can increase your endurance and performance. It can also increase your body’s immune system to fight injuries and sickness. It can speep your recovery from injury and it also makes you feel good. If you are having a hard time eating right, you might as well consider taking up dietary supplements to cover up for vitamin and mineral deficiencies in your body.

5. Manage stress. There are a lot of techniques devised to relieve stress, if not to eliminate it totally. Usually, stress is carried on the upper back, the shoulders, and the neck. If you prefer, go to your nearest orthopaedics to ask about these techniques and how to do them the right way.

6. Do not put pressure on your neck. For example, while using the telephone, do not use your neck and shoulders to hold it while you talk. In the office, always sit properly and keep your neck straight by working at eye level. You can unconsciously get neck pain during sleep because you are unaware of your movements. You can use a cervical pillow for this. You can also roll a towel and put it around the curve of your neck while you sleep. Never sleep on your stomach.

7. Stretch. It is always best to do stretching if possible. In the office or at home, you can take short breaks just to reduce the tension. Some massage won’t hurt either. It can decrease the tension not only on your shoulders but also on your neck.

Do not let yourself get weighed down by neck pain. If you are one of those people suffering from neck pain, do not fret. There are a lot of simple techniques and remedies you can get and use wherever you may be.

There are other risks as you sit in front of that computer but it would be to much to write about in this article, so if you would like to learn more about other risks such as:

Eye strain RSI (Repetitive Stress Syndrome) Carpal Tunnel Syndrome Constant Head Aches Dizziness Breathing Problems Difficulty Concentrating

CURE YOUR NECK PAIN TODAY! CALL +65 6471 2744 or Email to info@boneclinic.com.sg for Appointment

Torticollis, Wry Neck, Loxia

Torticollis is one of a broader category of disorders that exhibit flexion, extension, or twisting of muscles of the neck beyond their normal position. In torticollis your neck tends to twist to one side. The condition can either develop slowly if you have a family history of the disorder,acutely from trauma, or as an adverse reaction to medications.

Torticollis may be:

  • Inherited: Due to specific changes in your genes
  • Acquired: Develops as a result of damage to the nervous system or muscles

If the condition occurs without a known cause, it is called idiopathic torticollis.

Torticollis may develop in childhood or adulthood. Congenital torticollis (present at birth) may occur if the fetus’ head is in the wrong position while growing in the womb, or if the muscles or blood supply to the fetus’ neck are injured.

torticollis

Symptoms

  • Limited range of motion of the head
  • Headache
  • Head tremor
  • Neck pain
  • Shoulder is higher on one side of the body
  • Stiffness of neck muscles
  • Swelling of the neck muscles (possibly present at birth)

Exams and Tests

Various tests or procedures may be done to rule out possible causes of head and neck pain. A physical examination will show a visible shortening of the neck muscles and the head will tilt toward the affected side while the chin points to the opposite side. In more severe cases, the entire head pulls and turns to one side

A electromyogram (EMG) may be done in mild cases to see which muscles are most affected.

Treatment

Treatment of congenital torticollis involves stretching the shortened neck muscle. Passive stretching and positioning are treatments used in infants and small children. Such treatments are often successful, especially if started within 3 months of birth.

Surgery to correct the neck muscle may be done in the preschool years, if other treatment methods fail.

Acquired torticollis is treated by identifying the underlying cause of the disorder. Application of heat, traction to the cervical spine, and massage may help relieve head and neck pain. Stretching exercises and neck braces may help with muscle spasms.

Medications used to treat this condition include an anticholinergic drug called baclofen. Injection of botulinum toxin can temporarily relieve the torticollis, but repeat injections every 3 months are usually needed. Surgery is rarely used.

Outlook (Prognosis)

The condition may be easier to correct in infants and children. If the condition becomes chronic, numbness and tingling may develop as nerve roots become compressed in the neck.

The muscle itself may become large (hypertrophic) due to constant stimulation and exercise.

Botulinum toxin injections often provide substantial relief.

Possible Complications

Complications may include:

  • Muscle swelling due to constant tension
  • Neurological symptoms due to compressed nerve roots

Prevention

While there is no known prevention, early treatment may prevent a worsening of the condition.

Suspect Torticollis? Get professional opinion and treatment. Call +65 6471 2744 or Email to: info@boneclinic.com.sg to schedule for an appointment

Neck and Shoulder Pain

Are you experiencing neck and shoulder pain that is not getting better? You are at the right place. Cure your neck and shoulder pain today. Call us +65 64712744 or SMS to +65 92357641 to schedule for an appointment today.

Neck and shoulder pain can be classified in many different ways. Some people experience only neck pain or only shoulder pain, while others experience pain in both areas.

Neck Pain

Neck Pain

What causes neck pain?

Causes of neck pain include abnormalities in the bone or joints, trauma, poor posture, degenerative diseases, and tumors. Pain in the soft tissues (muscles, tendons, and ligaments) is the most common cause of neck pain and usually occurs as a result of an acute or a chronic muscle strain. The neck is very mobile, which means it is less stable than other areas of the body and more easily injured.

What causes shoulder pain?

The shoulder is a ball and socket joint with a large range of movement. Such a mobile joint tends to be more susceptible to injury. Shoulder pain can stem from one or more of the following causes:

  • Strains from overexertion
  • Tendonitis from overuse
  • Shoulder joint instability
  • Dislocation
  • Collar or upper arm bone fractures
  • “Frozen” shoulder
  • Pinched nerves (also called radiculopathy)

How are neck and shoulder pain diagnosed?

  • X-rays can be helpful in diagnosing neck and shoulder pain. Plain X-rays can reveal disc space narrowing, rheumatologic disease, destructive lesions, slippage, stenosis, fractures, and instability with flexion-extension views.
  • Magnetic resonance imaging (MRI) is a non-invasive procedure that can reveal the detail of neural (nerve-related) elements.
  • Myelography/CT scanning is sometimes used as an alternative to MRI.
  • Electrodiagnostic studies—electromyography (EMG) and nerve conduction velocity (NCV)also might aid in the diagnosis of neck and shoulder pain, arm pain, numbness, and tingling.

How are neck and shoulder pain treated?

The treatment of soft tissue neck and shoulder pain includes the use of anti-inflammatory medicine. Pain also might be treated with a local application of moist heat or ice. A local injection is often helpful for arthritis of the shoulder. For both neck and shoulder pain movement exercises can have positive results. For cases in which nerve roots or the spinal cord are involved, surgical procedures might be necessary.

Cure your Neck and Shoulder pain today. Call +65 6471 2744 or SMS to +65 92357641 to schedule for an appointment today.

Neck Sprain

A neck sprain is a stretched ligament or muscle in the neck. A neck sprain may occur without any obvious injury but sometimes it may be caused by a sudden impact with an object. An impact may force the neck to quickly extend beyond its normal range, and then snap back forcefully. This is commonly called a whiplash injury. Rear-end car accidents, head jerking during amusement park rides, or being kicked are the most common forms of impact that may cause a neck sprain.

What symptoms will I have with a neck sprain?

You will have neck pain that worsens with movement. Sometimes this pain will not appear until a full day or two after the event that caused it. You will most likely have neck stiffness that hinders your ability to move your neck. The back of your head might hurt. You may also have pain in the shoulders or upper back. Other symptoms that may happen with a neck sprain include:

  • Dizziness
  • Ringing in the ears
  • Fatigue
  • Patchy numbness in the hands or arms

If you notice these symptoms after a whiplash-type incident, see a doctor for an evaluation to rule out a more serious problem, such as damage to the spinal cord. Arm or leg weakness, difficulty walking, and an inability to control the bladder or bowels are signs of spinal cord injury. If you have immediate neck pain after the incident, go to an emergency room.

How is a neck sprain diagnosed?

A physical examination will review your posture, ability to move, and the position of your head and chin. The doctor will inspect the blood vessels in your neck and may listen to them with a stethoscope. He or she also may check:

  • The range of motion of your neck
  • The muscle strength in your arms
  • Your reflexes
  • Whether or not you can detect sensations

Imaging tests such as X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI) may be used, but most people with suspected neck sprain do not need these tests.

An MRI is a painless, noninvasive test that produces very clear pictures, or images, of the human body without the use of X-rays. MRI uses a large magnet, radio waves, and a computer to produce these images.

A CT scan is an X-ray procedure that combines many X-ray images with the help of a computer to create cross-sectional views of the body.

How is neck sprain treated?

Pain, inflammation, and tension may be treated by:

  • Analgesics and anti-inflammatory medications
  • Ice for the first 24 hours followed by heat applied to the neck through a moist towel
  • Muscle relaxants

Gentle movement of the neck is encouraged. Range of motion exercises may be prescribed by a physical therapist.

You may want to try sleeping with a rolled up towel under your neck for relief.

What can I expect from treatment?

Your head and neck pain should get better within a couple of weeks. If not, local anesthetic injections may be tried. Full recovery may take as long as 3 months. If you are still having symptoms after this time further evaluation by a spine specialist is appropriate.

Stop the pain and Get your Neck checked. Call +65 6471 2744 / Email: info@boneclinic.com.sg

Headache and Neck Pain

It is not uncommon to have a headache and neck pain at the same time. If you’ve been experiencing neck pain along with your headaches, there’s a good chance the two are related.

Most headaches don’t actually stem from pain in your brain tissue or skull — these tissues don’t have nerve fibers that allow you to feel pain. Most headaches are related to input from nerve fibers in your scalp. These nerves are connected to other parts of your body, including your neck muscles. Sometimes when a problem in your neck stimulates a nerve that leads to your scalp, it can cause a headache.

Neck Pain

Neck Pain

Neck Pain and Headache: Likely Causes
Headaches that occur along with neck pain are often caused by:

  • Stress. Tension headaches are often a result of stress, which can cause you to tense the muscles in your neck. A tension headache, also called a muscle-contraction headache, results from stiff, contracted muscles in and around the head. In addition to headache, neck pain and pressure are common symptoms of a tension headache.
  • Posture. When the head and neck are in an awkward position for a prolonged period, like when you’re balancing the phone between your ear and shoulder, you can experience both head and neck pain. Sleeping with inadequate head and neck support, such as on an airplane or with an overly flattened pillow, can also lead to poor posture and associated head and neck pain.
  • Poor lighting. When you are reading or doing other work without enough lighting, it can lead to eyestrain and stiffness in your scalp and forehead muscles, then to a tension headache and neck pain.
  • Gum chewing. Believe it or not, vigorous gum chewing can strain the muscles in your head and neck and be another cause of tension headache and neck pain.
  • Migraine headache. A migraine headache is an intense headache that’s thought to be related to the irritation of blood vessels in the brain. Sometimes, neck pain and stiffness are signs of an impending migraine headache.
  • Cluster headache. Cluster headaches are severe headaches that typically strike on one side of the head and tend to happen in batches, or “clusters,” around the same time of day for weeks or even months. Cluster headaches are often accompanied by tenderness in the neck.
  • Temporomandibular joint (TMJ) disorders. TMJ disorders are conditions affecting the jaw and neck that are often due to excessive jaw clenching or poor jaw alignment. Not surprisingly, TMJ can lead to both headaches and neck pain.
  • Meningitis. Meningitis is a serious, potentially life-threatening, infection of the meninges, the delicate tissue that encases the brain. Symptoms of meningitis often include headache, neck stiffness, and fever.
  • Post-traumatic headache. Trauma or an injury to your head and neck during a car accident, for instance, can lead to lasting headache, neck pain, and shoulder pain.

Neck Pain and Headache: When to See Your Doctor
If you have headaches associated with neck pain, it is important to talk with your doctor, especially if the pain is severe and you experience neck stiffness, fever, or sensitivity to light. While neck pain-associated headaches are usually the result of tension, they can sometimes be a sign of a more serious condition.

 STOP YOUR NECK PAIN AND HEADACHE TODAY. CALL US +65 6471 2744 OR EMAIL TO: info@boneclinic.com.sg FOR APPOINTMENT

Whiplash Injury

Pain in the neck, shoulders, head or the base of the skull that occurs after a motor vehicle accident is often called “whiplash.” Most patients with whiplash recover in a few weeks or at most, a few months, but 15 to 20% of people develop chronic pain. Whiplash is not a trivial problem, because once it has occurred, only 70% have recovered completely by one year and only 82% have recovered completely by two years. In addition to neck pain, there are many symptoms associated with the whiplash syndrome and include sleep problems, poor concentration and memory, blurry vision, ringing in the ears, fatigue, and weakness.

The treatment for whiplash syndromes depends on the stage and degree of the problem and which structures have been injured. In addition to soft tissue injury, pain that persists after four to six months is usually due to injury to the facet joints, one or more discs, or both. The diagnosis can usually be made by injections, MRI, and X-rays. Treatment is usually successful, but requires physical therapy, injections, and occasionally surgery.

Although long, the following is a review of whiplash.

The term, whiplash, is confusing because it is both a mechanism of injury and the symptoms caused by a car accident. It is due to a traumatic event that causes the head to move suddenly (“whip”) in one direction and then recoil in the other direction. The most common cause of whiplash is a motor vehicle accident in which one vehicle is struck from behind by another. However, it can occur when a car stops abruptly after striking a pole, a wall, or another car, and can also occur after a side impact.

Significant damage to ligaments, discs, and joints can occur even if the swings of extension and flexion are not excessive, but often the neck is forced to the extreme ends of normal range or beyond. Because the trauma is usually sudden, occupants of the car are not prepared for the impact. The muscles are relaxed, which allows more forces on the discs, ligaments and joints. Perhaps the most important fact about whiplash is that significant pain and structural damage can occur at crashes of low velocity.

Whiplash: The causes of the pain

It is the patient with persistent pain without any other specific findings on examination or specialized tests that presents the most problems for the patient himself or herself, the doctors, and the legal system. In the first few weeks to months after motor vehicle accident, it is often impossible to determine the exact cause or causes of the pain. The symptoms and signs are not sufficiently specific. In almost every instance, the muscles and ligaments have been strained and may be inflamed, painful, and tender. However after about 3 months, primary muscle or other soft tissue injuries usually have healed.

The most common causes of persistent pain in whiplash are the facet joints and the discs. There is a poor correlation between the radiographic appearance of the joints and whether they are painful. Some joints which look bad are painless while other joints that look normal can be proven to be a source of pain. Only facet injections can determine whether the joint is painful.

Whiplash: Associated symptoms

Many whiplash patients have symptoms which seem unexplainable, such as headaches, pain in the shoulders, between the shoulder blades, or in one or both arms.

There may be fatigue, dizziness, problems with vision, ringing in the ears, heaviness in the arms, and low back pain. There can be poor concentration or memory, change in emotions with irritability, depression or short temper, and sleep disturbance. Dizziness occurs in one-quarter to one-half of people with whiplash injury. Again, researchers are not sure of the cause. The most likely explanation is an injury to the part of the inner ear that regulates balance. Problems with memory and concentration can be due to the pain itself, depression, medications, or trauma to the brain. Visual disturbances occur in 10 to 30% of whiplash patients and blurred vision is the most common.

Long-term Outcome

Fortunately, most people who suffer neck pain after a whiplash injury will recover by six months. However, a small percentage of people continue to have pain.

Most patients destined to recover completely will have done so by three to four months, after which the rate of recovery slows markedly. By two years, essentially all patients have reached their individual maximum improvement. About 18% continued to have significant pain two years after the accident! Patients who did not get well tended to be older, had pain which began sooner after the accident, and/or had their head rotated to either side at the time of impact. They also found that patients who, before the accident, had a history of neck pain, arthritis of the neck, or headaches did not do as well.

Neck Pain, Whiplash and the Legal System

In our litigious society, it is fairly likely if a person develops neck pain due to a whiplash injury in a motor vehicle accident there will be a lawsuit. Common sense would tell us the greater the pain and impairment, the larger the legal settlement or award might be. Rarely, patients may exaggerate their symptoms or be faking. However, a bigger question is whether the potential for money from a legal settlement can unconsciously prolong or worsen the pain. This is called “secondary gain” and it is unconscious, not fraudulent.

To file in your Road Traffic Accident, Treatment and Investigation for your RTA, call us at +65 6471 2744 / info@boneclinic.com.sg

 

Physiotherapy in Neck Pain

The neck is the spinal structure that supports the head. It is the least protected structure compared to the rest of the spine. Due to its anatomical structure, the neck is highly vulnerable to injury and from conditions that produce pain and restriction of motion. Physiotherapy is a therapeutic management designed to restore the neck’s flexibility and maintain its normal range of motion. It comprises treatment options that are designed for the patient’s specific condition.

Causes of Neck Pain

  • Neck pain is a common medical condition. It may be due to biomechanical causes and injury arising from traumatic accidents or a standing medical condition. Common causes of neck pain may be due to muscle strain, disc herniation or degeneration, and worn-out cervical joints. A whiplash injury is another common neck injury that occurs due to a mobile accident with resulting extreme pain and injury to the neck.

Benefits

  • Physiotherapy provides several benefits in relieving neck pain. It can help maintain the strength of the neck muscles when under threat to be weakened by certain conditions such as spasm and pain. It also helps improve the flexibility of the neck muscles through the help of therapeutic neck exercises. Moreover, it adapts other forms of treatment such as manipulation, treatment modalities and massage that help improve the circulation and range of motion of the neck, which are vital to help relieve neck pain.

Types of Physiotherapy

  • Physiotherapy involves a variety of therapeutic approaches in managing neck pain. Common among the treatment options for neck physiotherapy are massage, manipulation, application of modalities such as hot or cold compresses, electrical stimulation and neck exercises. The aims of these types of therapeutic approaches to neck pain are to relieve inflammation, relax the cervical muscles, relieve neck pain, reduce compression to the cervical discs, strengthen the neck muscles and promote its muscular tensile strength, flexibility and mobility.

Physical Therapy Exercises

  • Because neck pain most frequently occurs due to muscular strain and injury, strengthening the neck muscles is vital in order to withstand cervical immobility and stiffness in the presence of neck pain. Stretching exercises improve the flexibility of the neck, which may become immobilized by pain. Basic range-of-motion exercises such as flexion, extension, side bending and rotation of the neck are done in gradual ranges that are tolerable to the patient. Neck exercises are integral in maintaining range of motion and warding off stiffness and pain.

Precautions

  • While the main goal of physiotherapy treatment is to help restore the normal function of the neck, there are still potential risks. It is important to be aware of any symptoms such as tingling or a numbing sensation during therapy as it may indicate neurological involvement such as nerve compression. Modalities such as electrical stimulation, traction, and hot and cold packs must also be used appropriately.