Un­di­ag­nosed whiplash a real pain in the neck

The Star Early Edition - - NEWS -

THOU­SANDS of pa­tients who go to doc­tors des­per­ate for help with neck pain are be­ing left in agony be­cause tra­di­tional scan­ning meth­ods are fail­ing to di­ag­nose it as whiplash, ex­perts have warned.

Too many doc­tors fail to look for in­jury in a spe­cific part of the body known as the cranio cer­vi­cal junc­tion. This is an area of bone be­tween the skull and the neck that is par­tic­u­larly vul­ner­a­ble to whiplash in­jury, caused by sud­den move­ment of the head for­wards, back­wards or side­ways.

The dam­age does not al­ways show be­cause stan­dard brain scans stop above this junc­tion, while nor­mal neck imag­ing ends be­low it.

Dr Steve Mor­gan of the Med­ser­ena Up­right MRI Cen­tre in Lon­don said: “It’s not an area com­monly scanned with rou­tine MRIs. The re­sult is that in­juries aren’t be­ing de­tected, so peo­ple are suf­fer­ing, some­times for years.”

Com­mon causes of whiplash in­clude car ac­ci­dents, a blow to the head – dur­ing sport such as boxing or rugby – and a slip or fall where the head is jolted back.

Symp­toms in­clude headaches as well as pain in the neck, shoul­ders and arms. Less com­monly, a pa­tient can suf­fer pins and nee­dles in the arms and hands, dizzi­ness, tired­ness, mem­ory loss, poor con­cen­tra­tion and ir­ri­tabil­ity.

The di­ag­no­sis of whiplash in­jury has be­come con­tro­ver­sial, after a dou­bling in the num­ber of com­pen­sa­tion claims in the UK re­lated to the con­di­tion in the past decade, many sus­pected to be ex­ag­ger­ated and fraud­u­lent.

In re­sponse, the Bri­tish gov­ern­ment has an­nounced a clam­p­down. Re­forms in­clude a £5 000 (R82 550) claim limit for whiplash, with a £2 000 thresh­old re­lat­ing to other per­sonal in­jury claims. A to­tal ban on per­sonal in­jury claims with­out med­i­cal ev­i­dence has also been pro­posed.

Many more pa­tients are told there is “noth­ing wrong” after scans fail to pick up an in­jury. Mor­gan says whiplash is “a very real prob­lem” and is call­ing for more pa­tients with per­sis­tent neck pain to be re­ferred to spe­cial­ists.

An on­go­ing study by Pro­fes­sor Fran­cis Smith, a pi­o­neer of MRI scans, has shown that tra­di­tional scan­ning prac­tices are in­ad­e­quate when it comes to pick­ing up whiplash in­juries.

It con­cludes that thor­ough MRI ex­am­i­na­tion of the neck is nec­es­sary, es­pe­cially of the cranio-cer­vi­cal junc­tion, the com­plex area of lig­a­ments and tough tis­sues that con­nect the top of the spine to the skull. Many sur­geons look in­stead for prob­lems with the in­ter­ver­te­bral discs.

Smith said: “In more than 200 pa­tients suf­fer­ing sus­pected whiplash in­jury that we’ve now scanned, about 60 to 70% have pre­vi­ously un­recog­nised prob­lems at the cranio-cer­vi­cal junc­tion.”

If the in­jury is de­tected, a sim­ple sur­gi­cal pro­ce­dure can be car­ried out to sta­bilise the joint, us­ing a screw-like im­plant.

Father-of-two Odd Bang­sund, 53, spent nearly 20 years on painkillers for con­stant headaches and suf­fered de­pres­sion after a mo­tor­bike ac­ci­dent in 1996. X-rays failed to de­tect an in­jury, as did a rou­tine MRI scan.

“I felt pow­er­less. I was in lots of pain around my head and neck but noth­ing showed up in the scans,” he said. In 2014, he fi­nally had surgery after an up­right MRI scan at the Med­ser­ena Clinic.

The scan, car­ried out when he was stand­ing up rather than ly­ing flat, re­vealed he had se­vere whiplash. His spinal cord was se­verely com­pressed and the ac­ci­dent had also caused major dam­age to his cranio-cer­vi­cal junc­tion lig­a­ments.

The scan­ner de­tected the whiplash be­cause as he was scanned stand­ing up, his head could be moved back into po­si­tions to re­veal the in­juries.

He said: “The pain is much bet­ter now, but I’ve suf­fered long-term dam­age be­cause it took years to get treat­ment.”

Tra­di­tional meth­ods fail­ing to de­tect it

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