Characterization of Acute and Chronic Whiplash-Associated Disorders

The Physiological Basis of Cervical Facet-Mediated Persistent Pain: Basic Science and Clinical Challenges

“…81,92,93 Those individuals who go on to develop persistent pain show signs of altered central pain processing, like diffuse mechanical hyperalgesia, thermal hyperalgesia, and/or lower thresholds to painful electrical stimulation, as early as 1 month after injury. 21,31,92,93 Patients with chronic pain exhibit primary mechanical hyperalgesia over the back of the cervical spine, in a "coat hanger" distribution indicative of peripheral nociceptor sensitization. 21,81 These patients are also hypersensitive to pressure, heat, and cold stimuli at sites distant from the cervical spine, including over the median, radial, and ulnar nerve trunks in the arm and over the tibialis anterior muscle.…”

“…4 Although sensitization processes contribute to protective sensation and are not always pathological, aspects of central sensitization can become pathological when they outlast the tissue injury and drive the persistence of pain. 4 In humans, clinical assessment of both evoked and spontaneous sensory (eg, sensitization) and emotional pain symptoms may be performed using a variety of quantitative sensory testing methods 20,31,99 and also with patient questionnaires. 91,93 These studies have identified the complex physical and psychological clinical presentation of whiplash and inferred relationships between the traumatic injuries sustained in whiplash and the clinical symptoms that develop.…”

Neck Pain: Much More Than a Psychosocial Condition

“…Specific topics include motor/muscle dysfunction associated with neck pain, 17 sensori-motor deficits and their association with symptoms such as dizziness, 13 cervical arterial dysfunction, 12 the complexity of whiplash-associated disorders, including the presence of central hyperexcitability, 4 as well as other innovative methods to measure factors such as respiratory physiology and muscle biochemistry. 15 There are also papers providing much needed critical information on the most commonly used outcome measure (The Neck Disability Index), 16 a systematic review of prognostic factors of outcome following whiplash injury, 24 and a clinical interpretation of a recent systematic review on physical management approaches for neck pain.…”

Behavior Change and Pain Relief in Chronic Whiplash Associated Disorder Grade IV Using Flotation Restricted Environmental Stimulation Technique: A Case Report

“…A recent review [2] of 226 research articles found that approximately 50 % of those with WAD transitioned to a chronic state. In a prospective follow-up study of 121 patients, 55 % of the cohort had severe clinical manifestations 17 years after their injury [3].…”

“…The two first conditions are defined as acute while condition three and four are defined as chronic because of their associated clinical implications and prolonged recovery [7]. Except from the before mentioned symptoms, WAD might also include but is not limited to neck pain, joint dysfunction, headache, dizziness, visual and auditory disturbances, insomnia, fatigue, paraesthesia, concentration and memory loss, anxiety and depression [2].…”