Where Does Chronic Neck Pain Come from After a Car Accident?
Chronic or Late Whiplash
is the term for pain following a car accident whiplash injury that persists beyond 6 months.
According to spine researchers Barnsley, Lord and Bogduk, between 15 and 40% of all car accident victims will devolve into chronic whiplash. The reason for the chronic pain is not muscle injury or tendon injury as many believe. Instead, these researchers have found the most common causes of long-term neck pain following a car crash is damage to the facet joints or intervertebral discs. Often it is both.
In chronic whiplash the pain the victim perceives may be confusing. Pain may originate in one structure and refer to a completely different area of the body. To distinguish which structures are the culprit for the lasting pain, the following descriptions may be helpful.
Pain from a malfunctioning or damaged facet joint is on the same side of the injury. The location will be along the side of the neck down to the area of the shoulder blade (scapula). The exact location along the neck or scapula will tell you approximately which facet joint is damaged.
Usually, a person with facet joint pain will be able to pinpoint an area in their mind of where the scapular pain is, and a careful doctor will be able to reproduce the symptoms by putting the suspected joints into combined extension and lateral flexion while pressing into the facet.
Most people equate shooting pains down the arm, numbness or tingling into the upper extremity the sign of disc problems in the neck. In reality those are symptoms of a nerve in the neck that is being irritated by a herniated disc or severe misalignment and inflammation within the spine. The disc materiel itself has its own nerve supply and when a sic is cracked or torn due to a whiplash injury, it will cause a predictable pain pattern at approximately the level of the offended disc, on the mid-line over the spinous processes. The pain is often reproduced by pressing down on the top of the head or having the patient hold their breath and bear down.
Chronic pain after a car accident indicates serious injuries have occurred
The presence of chronic pain post-whiplash means facet joints and/or discs have been damaged. These are permanent injuries and therefore need to be taken seriously. A simple muscle strain will heal in a matter of weeks, but not so for facet joints and discs. These structures cannot regenerate as muscle and bone tissue does. Once damaged they cannot go back to their original state. Complicating matters is the fact that they commonly deteriorate over time. Therefore, attempts by auto insurers to lump these injuries in with common and less serious muscle strains must be avoided by proper diagnosis and documentation.
Barnsley, L.; Lord, S.; Bogduk, N. (Sep 1994). “Whiplash injury.”. Pain 58 (3): 283–307