Abstract
IntroductionChronic neck pain after whiplash is notoriously refractory to conservative treatment, and positive radiological findings to explain the symptoms are scarce. The apparent disproportionality between subjective complaints and objective findings is significant for the planning of treatment, impairment ratings, and judicial questions on causation. However, failure to identify a symptom's focal origin with routine imaging studies does not invalidate the symptom per se. It is therefore of a general interest both to develop effective therapeutic strategies in chronic whiplash, and to establish techniques for objectively evaluation of treatment outcomes.MethodsTwelve patients with chronic neck pain after whiplash underwent pre- and postoperative computerized 3D gait analysis.ResultsSignificant improvement was found in all gait parameters, cervical range-of-motion, and self reported pain (VAS).ConclusionChronic neck pain is associated with abnormal cervical spine motion and gait patterns. 3D gait analysis is a useful instrument to assess the outcome of treatment for neck pain.
Highlights
Chronic neck pain after whiplash is notoriously refractory to conservative treatment, and positive radiological findings to explain the symptoms are scarce
Significant improvement was found in all gait parameters, cervical range-of-motion, and self reported pain (VAS)
Chronic neck pain is associated with abnormal cervical spine motion and gait patterns. 3D gait analysis is a useful instrument to assess the outcome of treatment for neck pain
Summary
Chronic neck pain after whiplash is notoriously refractory to conservative treatment, and positive radiological findings to explain the symptoms are scarce. Failure to identify a symptom's focal origin with routine imaging studies does not invalidate the symptom per se. It is of a general interest both to develop effective therapeutic strategies in chronic whiplash, and to establish techniques for objectively evaluation of treatment outcomes. [17,18,19] We have not, found any studies exploring if standard gait parameters are impaired as a result of upper body dysfunction, The present investigation was designed for that purpose and, secondly, to assess the usefulness of computerized 3D gait analysis to objectively monitor outcomes of treatment for neck pain Injections of Botox® to trigger points in superficial neck muscles have been shown to provide temporary but significant decrease in pain and increase in cervical ROM,[8] with similar effect of short duration from injections of local anesthetic to myofascial trigger points in the neck. [12] While rarely a definitive solution to problems associated with the chronic whiplash syndrome, such injections may be helpful in identifying focal origin(s) of soft-tissue pain. [12,13]
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