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Interpreting Radiology
Published in R. Annie Gough, Injury Illustrated, 2020
The most common radiology-based personal injury case is the rear-end collision resulting in neck pain and cervical injury. An Anterior Cervical Discectomy (ACD) is the typical repair procedure. A client gets hit from behind by a speeding, sleeping, distracted, or drunk driver. They suffer acute neck pain. Whiplash is a combination of muscle strain in the anterior and posterior cervical muscles and sprain to the facet joints between the bones. The vertebral discs between the spinal vertebra bones can also be injured, displaced, and/or herniated. When a disc is herniated, it has been torn and disc material is likely to protrude and touch the spinal nerve roots or the spinal cord. When cervical disc material is displaced and touching or compressing nerve fibers, pain radiates locally or down the arms, sometimes into the shoulders or hands and fingers. These injuries are complicated when a client is hit from the side, or from the front while their head was turned, or countless other scenarios. Regardless, this acute pain can become chronic. The common surgical repair when conservative treatment and physical therapy offer no relief is the ACD. I cannot estimate how many cases of clients surgically treated with ACDs come across the desks of attorneys on this continent. There are a lot of them. I have seen so many. Regardless I always strive to create the best ACD exhibits for the client, based on their specific anatomy and injury.
Regional injuries and patterns of injury
Published in Jason Payne-James, Richard Jones, Simpson's Forensic Medicine, 2019
Jason Payne-James, Richard Jones
Whiplash injuries associated with road traffic fatalities are very common and are caused by hyperextension of the neck; hyperflexion is less likely to cause damage. Hyperflexion injuries can be caused if heavy weights are dropped onto the back of a crouching individual; this scenario may be seen in roof falls in the mining industry. Hyperflexion injuries are also seen in sports – particularly rugby scrums and diving. Such injuries can cause fatalities or substantial disability such as quadriplegia.
Neck and shoulder pain
Published in Gill Wakley, Ruth Chambers, Paul Dieppe, Musculoskeletal Matters in Primary Care, 2018
Gill Wakley, Ruth Chambers, Paul Dieppe
Typical symptoms include headache, neck pain and stiffness, and back pain. Persistent pain is often complicated by other factors such as the frustration of having unresolved symptoms through no fault of their own, and long delays in resolving insurance claims. Adopt a sympathetic approach, and encourage patients to mobilise early, continue activity despite the pain, and take responsibility for their own recovery. Treat whiplash in the same way as other neck problems in order to help to reduce prolonged suffering.
Features and impact of dysphagia, dysphonia and laryngeal hypersensitivity in whiplash associated disorder – a qualitative study
Published in Disability and Rehabilitation, 2023
Danielle B. Stone, Trudy Rebbeck, Elizabeth C. Ward, James E. Elliott
High levels of persistent, chronic disability are observed in up to 50% of individuals presenting with Whiplash Associated Disorder (WAD) [1]. While recent studies highlight a widespread and multidimensional symptom profile [2–4], potential consequences such as dysphagia, dysphonia and laryngeal hypersensitivity have received minimal dedicated study. This knowledge gap was highlighted in a recent scoping review exploring the current understanding of swallowing- and voice-related problems following whiplash [5]. Although 18 papers were included in that review, level of evidence across studies was poor and none directly examined swallowing, voice and throat-related deficits [6–10]. A recommendation arising from the review was to conduct studies investigating these problems explicitly, utilising methods to establish a deeper understanding of these potentially under-recognised consequences of whiplash.
The effectiveness of general physical exercise for individuals with chronic neck pain: a systematic review of randomised controlled trials
Published in European Journal of Physiotherapy, 2020
Rutger M. J. de Zoete, Lauren Brown, Katie Oliveira, Liam Penglaze, Rachelle Rex, Bronte Sawtell, Tegan Sullivan
For the purpose of this review, studies investigating individuals with chronic idiopathic neck pain as well as chronic whiplash associated disorders were included. This was decided based on an initial search, revealing limited suitable articles for inclusion in this review if only one causation would have been chosen. Despite available evidence still being limited, even across these nine studies substantial differences were found in terms of duration of intervention (ranging 6–12 weeks), participants (idiopathic, traumatic or mechanical neck pain or a combination), control interventions (waitlist, usual care and neck-specific exercises) and methodological quality. As findings cannot be generalised across different neck pain populations due to differences in structural muscle changes [46], vestibular deficits [47] and widespread hypersensitivity to sensory input [5], it is difficult to weigh and interpret varying conclusions. Combining neck pain conditions in this review increased its heterogeneity, however, as it is believed that exercise may benefit a wide variety of chronic pain conditions this limitation may be considered relatively small.
Sex-based differences in pain distribution in a cohort of patients with persistent post-traumatic neck pain
Published in Disability and Rehabilitation, 2018
Hans Westergren, Johan Larsson, Michael Freeman, Anna Carlsson, Anna Jöud, Eva-Maj Malmström
Although not all traumas to the neck can strictly be regarded as whiplash trauma, it is a common neck injury mechanism, and the term is used in both the clinic and the literature to indicate a multitude of neck injury mechanisms. However, it is most commonly used to refer to an indirect trauma mechanism caused by acceleration–deceleration forces acting on the head and neck in a rear impact collision [5]. The result is an extra-physiologic movement in the cervical spine, which can cause injury to a variety of structures [6] including the zygapophyseal joints [7,8], stabilizing muscles [9–11], nerve structures [12], vertebral disks, and bones [13]. Beyond physical injury, whiplash trauma and its sequelae can cause psychological [14], cognitive [15], and social consequences [16]. This multitude of mechanisms, in combination with varied social situations and physical responses to the initial trauma, creates heterogeneity in the resulting clinical presentation.