whiplash mri Archives - Minnesota Physical Medicine Blog

Whiplash occurs when a person’s head is thrust forward or backward in a violent motion, over stressing the muscles and soft tissues in the area. The most common cause of whiplash is a car accident, especially accidents involving a rear-end collision. In this scenario the person who gets rear-ended will be thrust forward, but their head will usually snap backwards as their body is propelled forward.

Depending on the severity of the whiplash, most patients recover from their injury within 1-2 months, but others aren’t so lucky. For some, neck pain due to a whiplash injury becomes chronic, and symptoms remain for months or even years.

Luckily, we’re getting better at assessing whiplash symptoms and predicting who may suffer from long-term symptoms. With help from special MRI imaging, doctors are able to pinpoint with a fair degree of certainty which patients will develop chronic pain, disability and PTSD in the wake of a whiplash injury.

Chronic Pain Prediction

According to researchers at Northwestern Medicine, doctors can predict which patients will develop long-lasting symptoms within the first 14 days from the date of injury. By pinpointing which patients are likely to suffer long-term symptoms, doctors can better treat patients and help prevent potential setbacks down the road.

“This opens up a new door for research on whiplash,” said lead researcher James Elliott said. “For a long time whiplash has been treated as a homogenous condition. Our study has shown these patients are not all the same; they have different clinical signs and symptoms.”

The special MRI technique measures the fat/water ratio in the muscles of a person’s neck, and scientists uncovered that patients who would go on to suffer long-lasting symptoms had larger ratios of fat in their neck muscles. They believe this fatty infiltration could lead to atrophy of the muscles, and their findings were consistent no matter the size or BMI or the patient.

Elliot believes the findings may be most significant for individuals who suffer from PTSD in the wake of a whiplash injury or a traumatic car crash. If a person is deemed at-risk for emotional instability after an accident, doctors can help them get the treatment they need earlier, which can lead to better outcomes.

“These patients have shown to not respond well to traditional rehabilitation such as physical therapy,” Elliott said. “It appears that they may require a more concerted effort for pain management from their physician and help from a psychologist.” Emerging, yet preliminary evidence suggests this to be a reasonable strategy.

Whiplash injuries typically occur during a car accident, but they can happen during any event that causes your head and neck to move in in a violent manner. The majority of people who suffer a whiplash injury fully recover within a month or two, but for about 25 percent of the population, long-term pain and chronic pain persists.

Thankfully, we’re getting better at predicting which whiplash sufferers will have to deal with long-term effects through new MRI techniques. According to researchers, scientists can now predict which patients will develop chronic pain and partial disability within the first one to two weeks of the initial injury. They believe the earlier diagnosis will help doctors better develop a specialized treatment plan to treat the condition.

What The MRI Reveals

Researchers said the MRI reveals fat/water ratio in a person’s muscles, and unusual muscular changes one to two weeks post-injury can predict future chronic pain. The MRI uncovered that excess fat entering the patient’s neck is the key indicator.

“We believe this represents an injury that is more severe than what might be expected from a typical low-speed car crash,” says lead investigator James Elliott, assistant professor of physical therapy and human movement sciences at Northwestern University Feinberg school of Medicine. “This opens up a new door for research on whiplash. For a long time whiplash has been treated as a homogenous condition. Our study has shown these patients are not all the same; they have different clinical signs and symptoms.”

Elliott added that routine x-ray imaging does not reveal this fat infiltration, and the MRI appears to be an optimal route. Despite the findings, researchers haven’t pinpointed a preferred treatment option for whiplash sufferers who are at risk for future chronic pain.

“We haven’t found an effective treatment for these folks with chronic whiplash,” said Elliott.

Although they are still working on a solution, researchers said the findings are important because they help prove to whiplash sufferers that their chronic pain isn’t just in their head.

“If you’re a whiplash patient with ongoing chronic pain, but no objective imaging finds anything wrong, people are frequently informed that nothing is wrong with them,” Elliott says “It’s been a huge problem. That fat appears to be a response to an injury. What has actually been injured remains for us to find out. But now we know to look more deeply into the problem.”

Related source: Northwestern University