MATTERS
Now we don’t suppose for one fleeting moment that anyone has ever said that to any of you, dear readers... or have they? It’s possible, as ‘cervicalgia’ is the posh medical term for ‘pain in the neck’. And in our ongoing travels around the anatomy, and on the basis that “the head bone’s connected to the neck bone...” etc., we thought this time we’d take a look at some of the cause- and-effect information about neck pain.
According to the Association of British Insur- ers, more than 1,500 whiplash claims are made in the UK every day, costing the insur- ance industry more than £2 billion a year – and adding £90 to the average annual motor insurance premium. But just how many of those claims are legit? Well, despite the fall (hard to believe) in average insurance premi- ums, recent figures from the ABI have shown that the number of dishonest motor claims increased by 34 per cent to a record 59,900 in 2013, with a value of £811 million.
Actually, quite a few crucial elements of the ol’ bod are housed in one’s neck: for exam- ple, the first seven cervical vertebrae of the spine, some 37 joints, part of the spinal cord itself, a couple of carotid arteries, the thyroid gland, trachea (windpipe), oesophagus (food pipe), laryngeal prominence (Adam’s apple), larynx (voice box) and pharynx (works with oesophagus).
Obviously quite a lot goes on around these parts... it is no wonder expressions such as “stick your neck out”, “millstone round one’s neck”, and “put your neck on the line” came about, as the neck is rather worth looking after.
So what can go wrong, to cause that famous pain in the neck, stiffness, and any other dis- comfort in that particular region? We’ll start with the most familiar of all, and the most likely to have been suffered by taxi and private hire licence holders (or dare we say it, your pas- sengers) at some point in your lives: whiplash.
How about Cervical acceleration-decelera- tion?
HOW ABOUT CERVICAL ACCELERATION-DECELERATION?
This is the medical term for a range of injuries to the neck caused by or related to a sudden distortion of the neck. It is commonly associ- ated with motor vehicle accidents, usually from rear-end collisions; however the injury can be sustained in many other ways, includ- ing headbanging, bungee jumping and falls. The term ‘whiplash’ is a colloquialism, but one that has clocked up more injury claims – and dramatically accelerated our insurance premi- ums – than any other type of injury on record.
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It is during the retraction phase that the actu- al ‘whiplash’ occurs, as during the typical rear-end auto collision there is an unusual loading of soft tissues, followed by abrupt movement in any direction, usually sharply forward. Put aside your technical terms: if you’ve actually experienced a whiplash you’ll know the pain level that can be endured.
A major issue in whiplash prevention is the lack of proper adjustment of the seat safety system by both drivers and passengers. A properly placed head restraint where one can sufficiently protect his/her head lowers the chances of head injury by up to 35 per cent during a rear end collision. Over the past 40 years safety researchers have been design- ing and gathering information on the ability of head restraints to mitigate injuries; as a result, different types of head restraints have been developed by various manufacturers to protect their occupants from whiplash by minimising the rearward movement of the head and neck during rear impact.
So what actually happens anatomically when a genuine whiplash occurs? The event is divided into four phases: initial position (before the collision), retraction, extension and rebound. There are textbooks an inch thick written about the individual phases and their effects on the neck muscles and cervi- cal vertebrae; in fact this information became so technical that the Quebec Task Force divided whiplash-associated disorders (WAD) into five grades depending upon the severity of the injury/ies.
MEDICAL ‘DO YOU KNOW, YOU CAN BE A RIGHT CERVICALGIA?!’
In most passenger vehicles where manually adjustable head restraints are fitted, proper use requires sufficient knowledge and aware- ness by occupants. But because of low public awareness of the consequence of incorrect positioning of head restraints, some vehicle manufacturers have designed and implemented a range of devices into their models to protect their occupants. Amongst those manufacturers are Mercedes Benz, on their A-Class and C-Class; Saab, Opel, Ford, Nissan, Subaru, Hyundai, Peugeot, Volvo, Jaguar and Toyota.
Interestingly, in times past the first thing they did following a whiplash accident was to shove a soft collar round one’s neck. These days the use of a collar is contra-indicated; they say that flexing the neck muscles is bet- ter for recovery than holding the neck still.
Modern treatment for whiplash spans the usual range of painkillers: paracetamol, NSAIDS (anti-inflammatories such as aspirin or ibuprofen), co-codamol; as well as possi- ble steroid injections, acupuncture and massage therapy. As mentioned, the collar has fallen out of favour; the best programme of recovery recommends an active rehabilita- tion schedule that includes physiotherapy exercises and postural modifications, all under the guidance of a health professional.
Other causes of neck pain OTHER CAUSES OF NECK PAIN
Because your neck is flexible and supports the weight of your head (about ten pounds), it can be vulnerable to various conditions that cause pain and restrict motion. As with any other sort of bodily discomfort, often the accompanying symptoms will determine the cause.
First step always is to check it out with one’s GP. Following initial chat and examination, it may be recommended that a series of tests be carried out to determine the underlying cause: a physical exam may include feeling for points of tenderness, testing range of motion, and/or performing a complete neurological exam of the upper and lower extremities to detect pos- sible cervical spine injury.
If severe trauma has occurred and fracture or instability is suspected, X-rays may be ordered if symptoms have persisted for 30 days or more; similarly, CT and/or MRI, EMG, nerve conduction, and laboratory studies may be ordered.
Twisted or locked neck: Some people sud- denly wake up one morning to find their neck
OCTOBER 2015
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