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The only way to tell if the joint is a cause of pain is to perform an injection called 'medial branch block MBB ,' which is discussed below. Disc injury can also cause chronic neck pain. The disc allows motion of the neck, but at the same time keeps the neck from moving too much. The outer wall of the disc called the annulus can be torn by a whiplash injury. This usually heals, but in some people, the disc does not heal. In that case, it might get weaker and hurts when stressed during normal activities. The pain comes from the nerve endings in the annulus.

Less often, a disc can herniate and push on a nerve. This usually causes more arm pain than neck pain. Muscle strain of the neck and upper back can cause acute pain. However, there is no evidence that neck muscles are a primary cause of chronic neck pain, although muscles can hurt if they are working too hard to protect injured discs, joints or the nerves of the neck, or if something else is wrong that sustains the muscle pain, such as poor posture and work habits.

Spinal nerves and the spinal cord can be compressed by a herniated disc or bone spur. This usually causes arm pain, but there can also be neck pain. Headache caused by neck problems is called cervicogenic or neck-related headache. It may be caused by injury to an upper cervical disc, facet joint or higher joints called the atlanto-occipital or atlanto-axial joints.

Cervicogenic headache can also make migraines worse.

Arm pain and heaviness may be caused by nerve compression from a herniated disc, which is easy for your health care professional to diagnose. More commonly, arm pain is 'referred' from other parts of the neck.


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Pain between the shoulder blades is usually a type of referred pain. Low back pain is occasionally seen and is quite common after whiplash and may be caused by injury to the discs, facet joints of the low back or sacroiliac joints. Difficulties with concentration or memory can be attributed to the pain itself, medications you are taking for the pain, depression or mild brain injury.

You might also experience irritability and depression. Sleep disturbance can be a result of pain or depression. Other symptoms might include blurry vision, ringing in the ears, tingling in the face and fatigue. The treatment of whiplash in the first few weeks and months usually involves strength training and body mechanics instruction. Patients who do not get better after about 12 weeks require specialized treatment, often from a spine specialist, based on the cause of the pain.

Strength training is necessary to develop sufficient muscle strength to be able to hold the head and neck in positions of good posture at rest and during activity. Strengthening the muscles will also improve their range of motion. Body mechanics describes the interrelationship between the head, neck, upper body and low back during movement and at rest. Training in proper posture decreases the stress on muscles, discs and vertebrae, giving damaged tissue the chance to heal. Poor posture and body mechanics unbalance the spine and create high stress on the neck, which may impede healing.

Medications are helpful for symptom control. They never solve the problem and should be used as just one part of a total treatment program. There is no best medicine for neck pain. The choice of medication depends on the type, severity and duration of the pain as well as the general medical condition of the patient. Types of medications that are most often prescribed for acute neck pain include antiinflammatory drugs and opioid narcotic pain relievers.

Additionally, your health care professional may prescribe the use of muscle relaxants. For chronic and severe neck pain, the opioid analgesics and antidepressants are generally most helpful. Spinal injections can be helpful in carefully selected patients. Again, injections do not cure the problem and should be only one part of a comprehensive treatment program. Epidural injections into the spinal canal can provide short-term relief in cases of nerve compression with arm pain, but are rarely effective for pure disc pain without radiating symptoms.

Facet zygopophysial injections may help temporarily with neck pain and are usually tried before radiofrequency neurotomy. Radiofrequency neurotomy RFN is a procedure that heats the nerves to stop them from conducting pain signals but is only useful for facet joint pain. It can help for about nine to 18 months and then can be repeated if needed and should only be considered in chronic situations with significant pain. Spinal manipulative therapy SMT is usually provided by chiropractors, osteopaths or specially trained physical therapists.

SMT can provide relief from symptoms for many patients and is generally safe.

SMT should be combined with strength training and body mechanics instruction. Your neck may be painful but keeping it mobile from an early stage will improve its functionality and speed up your recovery. Painkillers, such as paracetamol and non-steroidal anti-inflammatory drugs NSAIDs , such as ibuprofen , can be used to help relieve the pain. Whiplash that lasts for six months or more is sometimes known as chronic whiplash or late whiplash syndrome. For example, if you have severe pain, your GP can prescribe a stronger painkiller, such as codeine, or they may recommend physiotherapy.

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Through Time Whiplash

Read more about how whiplash is treated. In most cases, whiplash eventually gets better without causing any lasting damage. However, in a small number of cases, the pain can last for six months or longer chronic whiplash. It may also cause problems at work and could lead to anxiety and depression.

How Does Whiplash Occur?

See your GP if you have chronic neck pain that's causing problems with work and preventing you from carrying out normal, everyday activities. Read more about the complications of whiplash. You may also experience headaches , muscle spasms and pain in your arms or shoulders. If you have whiplash, the ligaments in your neck will be overstretched. This is known as a sprain. Hyperextension and hyperflexion are where the tendons and ligaments of the neck are forcefully extended or flexed beyond their normal limits.

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Although the ligament isn't broken, a sprain can often take a long time sometimes several months to heal. After an accident, the symptoms of whiplash often take a while six to 12 hours to develop. Any inflammation and bruising in neck muscles won't usually be evident at the time of the accident. Whiplash is usually short lived and self-limiting it gets better on its own , but in a small number of people the symptoms persist beyond six months.

This is known as chronic whiplash or late whiplash syndrome see below. Following a whiplash injury, symptoms of headaches and dizziness should only last for a short time. See your GP if they persist. Read more about how chronic whiplash is treated. However, sometimes whiplash can cause a number of severe and troublesome symptoms that last for a long time.

If you have whiplash, it's important to keep your neck mobile by doing some gentle neck exercises. Any pain you experience when moving your neck is normal and won't cause further damage. If you rest your neck and keep it still it's likely to prolong your symptoms and delay your recovery.

Predicting Outcomes in Whiplash – Physioplus

Therefore, wearing a neck brace or collar isn't recommended. Paracetamol is recommended to treat mild neck pain.

You should use it regularly rather than only when the pain is most severe. If your neck pain is severe, your GP will be able to prescribe a stronger painkiller, such as codeine.