Whiplash Injury
Ross Hauser, M.D.
 

The term "whiplash" describes an injury of sudden hyperextension followed by hyperflexion of the neck. When no objective signs of damage to the cervical spine are found on radiography and no clinical signs of nerve root damage appear, the injury is termed whiplash injury or neck sprain injury. A significant proportion of the patients have long-lasting symptoms, disabling some of them for long periods of time.

In whiplash injuries, headache or neck pain often does not come on immediately. It can build over several weeks, to become horrible several weeks after the injury. The injury may not have even been considered significant at the time it occurred.

The most common symptoms after whiplash injury are neck pain, neck stiffness, headache, shoulder pain, back pain, and difficulties with concentration and memory. Dizziness, buzzing in the ears, insomnia, depression, and anxiety are also reported.

To accurately diagnose the cause of neck or head pain, a listening ear and a doctor's strong thumb (for palpatory examination-to press on and isolate the pain causing area) are generally all that is needed. Diagnostic tests, such as x-ray, CAT and MRI scans cannot diagnose the source of pain. As a matter of fact, they often lead the patient and physician astray.

MRIs Can Lead You Astray
In a large study published in 1998 at The Keio University School of Medicine, 497 people with absolutely no neck or head pain or injury were given MRI scans of their necks. The results were as follows:

In those people in their 20s: Seventeen percent of the men and 12 percent of the women had abnormalities of disc degeneration.

In those people in their 60s: This percentage climbed dramatically as 89 percent of men and 86 percent of women had evidence of disc degeneration. (Matsumoto, M. et. al. MRI of cervical intervertebral discs in asymptomatic subjects. The Journal of Bone and Joint Surgery. 1998; 80B:19-24.)

This study just tells you how misleading MRI scans can be. Approximately 90 percent of people over 60 years of age supposedly exhibited arthritis in the neck, but they were totally asymptomatic. This does not require a surgical consult. Guess what would happen if the people had neck pain in addition to these findings on MRI? They would get surgical consults, possibly ending up with surgery because of the disc degeneration and arthritis.

Prolotherapy as a Treatment for Head and Neck Pain
The areas to be treated with Prolotherapy are determined by palpatory examination of the posterior head and neck. Again, the accuracy in diagnosing the actual pain-producing area is excellent, because the physician recreates the patient's pain by palpating the neck and posterior head carefully until a positive jump sign is elicited. This gives the patient and the physician confidence that the pain-producing structure is between the physician's thumb and the underlying bone. The structures that are typically involved are the cervical vertebral ligaments. These tender areas are treated with Prolotherapy injections. (Watch where do Prolotherapy injections go and do they hurt?) Typical areas treated during Prolotherapy sessions for chronic headaches and neck pain are the base of the skull, cervical vertebral ligaments, posterior-lateral clavicle, where the trapezius muscle attaches, as well as the attachments of the levator scapulae muscles. Because there is an anesthetic in the solution, generally the neck or headache pain is immediately relieved. This again, confirms the diagnosis both for the patient and the physician.

Dr. Hackett reported good to excellent results in 90 percent of 82 consecutive patients with neck and/or head pain whom he treated with Prolotherapy. (Hackett, G. Prolotherapy for headache. Headache. 1962; 1:3-11. / Hackett, G. Prolotherapy in whiplash and low back pain. Postgraduate Medicine. 1960; pp. 214-219.)

Dr. Kayfetz and associates treated 206 patients who had headaches caused from trauma. They found that Prolotherapy was effective in completely relieving the headaches in 79 percent of patients. (Kayfetz, D. Whiplash injury and other ligamentous headache-its management with Prolotherapy. Headache. 1963; 3:1-8.)