I regularly see patients who have been told by another doctor that they need surgery for neck instability, or who have already had a failed cervical spine surgery.
Why do so many patients undergo neck surgery? One reason is their fear that symptoms may progress. Another is that they are sometimes told they may be risking paralysis without it. Most commonly, though, it is because the doctor does not know how to heal neck pain due to ligament injury. (more…)
Hyper-extended neck injuries, more commonly referred to as whiplash, are a complex problem for patients. A complexity that leaves many frustrated with their health care and some fighting to prove that there is something really wrong with them. If one were to examine the research on whiplash related disorders, he/she would find that most of the new studies center around identifying those patients who cannot be helped or feel helpless.
- In one study doctors found that individuals with whiplash associated disorders reported more additional causes of pain, more painful locations and higher pain intensity than individuals with chronic pain from other causes.1
- Patients with whiplash related disorders also have a greater fear of movement, so much so that some doctors are calling for revising standardized tests to determine the extent of the patient’s problems.2
- Further, doctors are seeking reasons why some people recover within months and others report symptoms for extended periods and found a strong and plausible association, as did the study above, between severe disability, clinical levels of pain, catastrophizing and low mental health. 3
Fast initial treatment after injury + Slowly developing symptoms = delayed healing
There have been many papers over the years which questioned whether whiplash patients should receive early intensive care. Some papers found early care not to be of benefit, others found it detrimental. Recently investigators tested the early care option and this is what they reported:
“Individuals with high utilization health care had slower recovery independent of expectation of recovery and other confounders. Compared to individuals who reported low utilization of physician services, recovery was slower for those with high health care utilization regardless of the type of profession. ”
The less medical care the faster they recovered
- those who went to their doctor and then were referred to physiotherapy had significantly slower recovery.
- those who went to the doctor and were referred to the chiropractor had significantly slower recovery.
- those who went to the doctor and then to massage therapy had significantly slower recovery.4
So at the time of the accident or sports impact, the victim may have reported that they felt great, but then a day, two days or a week later, suddenly, they would start developing pain in their neck, shoulders and back. When it was reported to the doctor – intensive care was started. This may include painkillers which I write about frequently as causing delayed or inhibited healing on their own.
Waiting for the whiplash injury to develop
In a whiplash injury, your head snaps back, then snaps forward. This snapping back and forth can be severe – even in low speed impact. That delicate S-shape, where the neck’s anatomical structures are properly lined up is compromised and injuries can occur.
Injuries can be to the vertebrae or the soft tissue that supports them. The neck ligaments can be torn or stretched, the tendons that attach the muscles to the bones can similarly be damaged as well as muscles.
While damage to bones are readily seen in X-ray, damage to the ligaments, tendons, and muscles may not get picked up, even by the most sophisticated imaging devices.
Treating cervical ligaments with Prolotherapy
The use of Prolotherapy for neck and whiplash related symptoms was first published in 1962.5 Recently you read about advances we are making here at the Darrow Wellness Institute by way of the science of Orthobiologics. Orthobiologics is a medicine where your own body supplies the healing solutions needed for joint repair. This can be blood plasma or bone marrow derived stem cells.
Despite these significant advances, sometimes, following a consultation, we find that all the patient needs is a little dextrose Prolotherapy. A very simple solution to a very complex problem of neck instability. In instances of treating neck pain and whiplash related symptom disorders, researchers have studied the impact of whiplash and repetitive force injuries on the neck with special interest on the failure of the cervical ligaments 5
Do you have a question for Dr. Darrow?
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1. Myrtveit SM, Skogen JC, Sivertsen B, et al. Pain and pain tolerance in whiplash-associated disorders: A population-based study. Eur J Pain. 2015 Nov 16. doi: 10.1002/ejp.819. [Epub ahead of print]
2. Vernon H, Guerriero R, Kavanaugh S, Puhl A. Is “fear of passive movement” a distinctive component of the Fear-Avoidance Model in whiplash? J Can Chiropr Assoc. 2015 Sep;59(3):288-93.
3. Casey PP, Feyer AM, Cameron ID. Course of recovery for whiplash associated disorders in a compensation setting. Injury. 2015 Nov;46(11):2118-29. doi: 10.1016/j.injury.2015.08.038. Epub 2015 Sep 3.
4. Skillgate E, Côté P, Cassidy JD, Boyle E, Carroll L, Holm LW. The effect of early intensive care on recovery from whiplash associated disorders – Results of a population based cohort study. Arch Phys Med Rehabil. 2016 Jan 22. pii: S0003-9993(16)00035-6. doi: 10.1016/j.apmr.2015.12.028. [Epub ahead of print]
PubMed PMID: 26808783.
5. Hackett GS, et al. Headache. Prolotherapy for headache. Pain in the head and neck, and neuritis. 1962 Apr;2:20-8.
6. Bass CR, Lucas SR, Salzar RS. Failure properties of cervical spinal ligaments under fast strain rate deformations. Spine (Phila Pa 1976). 2007 Jan 1;32(1):E7-13.