Undiagnosed whiplash a real pain in the neck
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