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Inside Sources of Pain
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Sources of pain

When the cervical spine (neck) is subject to a whiplash injury, there is usually a combination of factors that contribute to the pain. These factors must be addressed individually, while maintaining a "holistic" view of the patient.

The most significant factors may include one or more of the following:

1. Joint dysfunction
2. Muscle dysfunction
3. Faulty movement patterns
4. Disc derangement

1. Joint dysfunction
This occurs when one of the joints in the spine or limbs loses its normal joint play (resiliency and shock absorption). It is detected through motion palpation, a procedure in which the doctor gently moves the joint in different directions and assesses its joint play. When a joint develops dysfunction, its normal range of movement may be affected and it can become painful.

In addition, joint dysfunction can lead to a muscle imbalance and muscle pain and a vicious cycle:

2. Muscle dysfunction
When joint dysfunction develops, muscles are affected. Some muscles respond by becoming tense and overactive, while others respond by becoming inhibited and underactive. In either case, these muscles can develop trigger points.

Trigger points are areas of congestion within the muscle where toxins accumulate (2). These toxins can irritate the nerve endings within the muscle and produce pain. This pain can occur in the muscle itself or can be referred pain (perceived in other areas of the body).

The muscle can also send abnormal neurological signals into the nervous system. This can then cause disruption of the ability of the nervous system to properly regulate muscles in other parts of the body, leading to the development of faulty movement patterns.

3. Faulty movement patterns
It is thought that the intense barrage of pain signals from a traumatic injury to the cervical spine can change the way the nervous system controls the coordinated function of muscles (3). The disruption of coordinated, stable movement is known as faulty movement patterns.

Faulty movement patterns cause increased strain in the muscles and joints, leading to pain. They can involve the neck itself or can arise from dysfunction in other areas of the body such as the foot or pelvis.

Instability is also considered part of faulty movement patterns. There are 2 types of instability that can occur in whiplash (3):

As a result of instability, even mild, innocuous activities can become painful.

4. Disc derangement
The force of whiplash can cause injury to the discs between the vertebrae and small tears can develop. If the gelatinous middle of the disc seeps out it can irritate the nerve endings in this area. This is known as disc derangement.

Occasionally, the gel can seep all the way out and press on a nerve root exiting the spinal cord behind the disc, known as disc herniation. This may involve pain in the neck as well as sharp, shooting pain down the arm and possibly neurological symptoms such as numbness, tingling and muscle weakness.