Your Doctor May Be Wrong!!! Nagging, Chronic Neck Pain Following a Car Accident May not be Soft Tissue. These Cervical Spine Injuries May be a More Serious Injury: Facet Joint Injury
Neck pain is one of the most common chronic pain conditions in modern medicine. Chronic neck pain following whiplash injuries from car accidents is a common phenomenon. Moreover, chronic pain is commonly associated with such debilitating symptoms as depression.
When subjected to acceleration-deceleration forces (otherwise known as "whiplash"), the spine moves in very unusual ways. This is particularly so with regard to the neck (known as the cervical spine). The neck is a particularly weak part of the spine because it area is supported by very little musculature and, during an accident, is moved with tremendous force. When the neck is moved quickly and forcefully, the movement puts a tremendous
strain on the facet joints of the spine -- which are located at the rear of the spine and act as joints between individual vertebrae. The facet joints allow the spine to move in a very flexible manner through flexion and extension.
Acceleration-deceleration injuries have immediate effects stemming from conditions such as unilateral fractures the facet joints, micro fractures, facet subluxation, ligament and muscular tears, and hemorrhage or edema of the pariarticular tissues. When an injury involves a lower cervical sets, shoulder or arm pain is a typical symptom. The pain is usually sharp, cramping, and burning and is usually associated with a constant deep, dull, boring age in the cervical spine. Injured people often describe the sensation as a grinding, twisting, crunching, or snapping sensation that companies neck movements. Surprisingly, weakness and numbness are not found.
Injured people with cervical facet syndrome usually present with severe posterior neck pain and muscle spasms. Outpatient to the neck produces pain over the cervical facets. The pain increases with hyper extension of the neck. However, there are no long track neurologic findings. When an injured person presents with symptoms of pain overlying the cervical facet joints, there is a good possibility that the joints are involved in the pain. Injured people
usually report pain in the neck and shoulder area with associated headaches and ear pain.
Unfortunately radiographic diagnoses of these injuries is very difficult. Cervical spine x-rays will reveal focal or diffuse cervical spondylosis, but will not reveal the facet injury itself. Cervical facet blocks at the appropriate level are the mainstay of the diagnosis of cervical facet pain. Cervical facet block at the appropriate level usually brings immediate relief to the injured person. Pain relief for at least three weeks is diagnostic prove a facet origin pain.
Lumbar facet joint pain can also be diagnosed in the same way. However, lumbar facet joint injuries are far less likely to occur following an auto accident. This is because the lower back (lumbar spine) is generally supported and not subject to fast and extreme range of motion accelerations following a rear end car accident. This is different than the neck (cervical spine) which can only rely on a headrest for protection from these quick acceleration injury (whiplash).
How are cervical facet joint injuries treated? One method is via radiofrequency (RF) rhizotomy which ends up denervating the nerves that run along the spine.
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