Pain in the Neck: Just Don’t Call It Whiplash

Shortly after the introduction of the Motel T, the term ‘whiplash’ came into being— and it never went away. While orthopedic specialists have yet to find a physiological source for this condition, the ‘industry’, if you will, now costs us about $20 billion every year. Surely all these cases can’t be caused by car crashes!

One surgeon, writing for the American Association of Orthopaedic Surgeons (AAOS), contends that ‘whiplash’ is actually an injury to the upper back— specifically, the supraspinatus muscle. Other culprits could be the trapezius muscles, trigger points, thoracic outlet, or fibromyalgia, he says.

Or maybe, just maybe, whiplast isn’t one phenomenon. Maybe it can be caused by a number of factors, and can manifest itself in different ways.

Everybody wakes up with a stiff neck once in a while. Maybe you slept wrong. Or you spent too much time at your desk, neck crinked and eyes focused on the monitor. It usually hurts for a day or two, and then you forget about it.

But if neck pain doesn’t go away or it keeps coming back, maybe you’ve been advised— by your know-it-all colleague, for instance— that you have whiplash.

Maybe You Should Get a Better Diagnosis?

Before we get into the details, let’s take a little quiz:

• Does your neck pain radiate down your arm?
• Do you sometimes feel a lack of coordination in the arms or legs?
• Does the weather affect your neck?
• Do you have a job that requires prolonged periods of overhead work?
• Do you sometimes hear a grinding or popping noise in your neck?

Based on your answers to those questions, as well as a physical exam and your medical history and lifestyle, we can arrive at a diagnosis— something more precise than whiplash— and decide on a treatment plan.

We usually test the most common assumptions first— a technique known as Occam’s Razor— before moving on to more esoteric possibilities. Arthritis fits into that category.

If you are over 40, chances are you have some degenerative arthritis. By the time you reach 60, you have an 85% chance of suffering from cervical spondylosis, as it’s called. This disease is characterized by a wearing away of the cartilage, which can result in the infamous bone-on-bone syndrome. Or the spine may be growing new bones to help support the vertebrae. Such bone spurs may squeeze the space the nerves pass through, creating a condition called stenosis.

Risk factors for cervical spondylosis include age; smoking; occupation (overhead work); mental health issues such as depression or anxiety; injuries (whiplash!); or genetics. If Grandpa had neck pain, chances are you will, too.

Treating the Symptoms of Neck Pain

There are various ways of managing the condition. We can’t stop degenerative arthritis, but we can relieve pressure and pain. Physical therapy is a popular option. Modalities (therapeutic tools) include traction and posture therapy, such as showing you how to sleep and how to support your neck while you’re at your desk.

If there is pain and swelling, we may recommend ice, heat or massage to relieve the discomfort.

Steroid injections are fairly common, and they provide some short-term relief. (Again— it bears repeating— the process of arthritic degeneration will not be arrested. Only the discomfort will be relieved; the condition won’t be ‘cured’.)

In the case of a herniated disk in the cervical (neck) area, we may prescribe an epidural block. With this procedure, a steroid and painkiller are injected into the epidural space around the spinal cord.

Surgery is seldom prescribed for neck pain, unless you have progressive neurologic symptoms, such as weakness, numbness or losing your balance— any of which may indicate nerve impingement.

Bottom line: We can relieve your symptoms. If you have neck pain that recurs frequently or doesn’t go away after a day or so, call the clinic. Just don’t call it whiplash.