From: BMC Musculoskelet Disord. 2010 Feb 9;11(1):29. [Epub ahead of print]
Cervical spine pain and dysfunction resulting from a motor vehicle collision motor vehicle collision are common patient problems encountered by health care practitioners. Many patients will significantly recover with respect to neck pain and disability within the first six months to one year. Researchers have reported that 32% to 56% of those that have sustained a motor vehicle collision will continue to suffer pain and disability beyond the six month period.
The cervical zygapophyseal joint has been implicated as a source of pain in those with chronic whiplash associated disorders . Studies utilizing controlled, comparative anaesthetic nerve block procedures have reported that the prevalence of cervical zygapophyseal joint pain in those with chronic whiplash associated disorders ranged from 54% to 60%. Biomechanical and neurophysiological studies have provided evidence in support of cervical zygapophyseal joint involvement in motor vehicle collisions.
Research has indicated that the ongoing pain associated with chronic whiplash associated disorders may be due to altered pain processing as evidenced by sensory hypersensitivity at distant sites involving uninjured tissues. Central nervous system hyperexcitability may provide an explanation for the generalized sensory hypersensitivity seen in some patients with chronic whiplash associated disorders. Sensory hypersensitivity is characterized by decreased pain thresholds to mechanical, thermal, and electrical stimuli. The presence of sensory hypersensitivity, in particular cold hyperalgesia, in whiplash patients has been associated with a poor prognosis. The precise mechanisms underlying sensory hypersensitivity are unclear, but peripheral, spinal, and supraspinal mechanisms have been hypothesized.