Citation

Elliott JM. Spine 2011; 36(25 Suppl): S205-10.

Affiliation

Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

Copyright

(Copyright © 2011, Lippincott Williams and Wilkins)

DOI

10.1097/BRS.0b013e3182387f57

PMID

22020614

Abstract

Study Design. Literature review.Objective. To review the evidence related to the morphological changes (atrophy and fatty degeneration) of neck muscles in whiplash-associated disorders (WAD) and to highlight emerging evidence for the pathophysiological mechanisms behind muscle degeneration and their potential role in the transition from acute to chronic pain following whiplash injury from a motor vehicle crash (MVC).Summary of Background Data. Magnetic Resonance Imaging (MRI) can be regarded as the gold standard for muscle imaging. There is emerging evidence to highlight in-vivo features of neck muscle degeneration in patients with chronic WAD as well as the temporal development of such acute changes following MVC. However, the precise underlying mechanisms for such changes and their influence on functional recovery following whiplash remain largely unknown.Methods. Literature review of available evidence from both the authors' previous studies and other similar bodies of work.Results. Studies have quantified degenerative changes in the neck muscles of patients with acute and chronic whiplash with structural MRI applications.Conclusion. Current evidence from structural MRI based studies demonstrates the widespread presence of fatty infiltrates in neck muscles of patients with chronic whiplash. Such findings have not shown to feature in patients with chronic insidious onset neck pain, suggesting traumatic factors play a role in their development. Recent studies have revealed that muscle fatty infiltrates manifest soon following whiplash but only in those with higher pain and disability and symptoms of post-traumatic stress disorder. The possibility that such muscle changes are associated with a more severe injury including poor functional recovery remains the focus of current research efforts.

Language: en