A distinct pattern of myofascial findings in patients after whiplash injury.
OBJECTIVE
To identify objective clinical examinations for the diagnosis of whiplash syndrome, whereby we focused on trigger points.


METHODS
A cross-sectional study with 1 measurement point.


METHODS
A quiet treatment room in a rehabilitation center.


METHODS
Patients (n=124) and healthy subjects (n=24) participated in this study. Among the patient group were patients with whiplash-associated disorders (n=47), fibromyalgia (n=21), nontraumatic chronic cervical syndrome (n=17), and endogenous depression (n=15).


METHODS
Not applicable.


METHODS
Each patient and control subject had a manual examination for trigger points of the semispinalis capitis, trapezius pars descendens, levator scapulae, scalenus medius, sternocleidomastoideus, and masseter muscles bilaterally.


RESULTS
Forty (85.1%) of the patients with whiplash had positive trigger points in the semispinalis capitis muscle. The patients with whiplash had a significantly higher prevalence of positive trigger points in the semispinalis capitis muscle than any of the control groups (P<.05). For the other examined muscles, the prevalence of trigger points in the patients with whiplash did not differ significantly from the patients with fibromyalgia or nontraumatic chronic cervical syndrome. It did differ from the patients with endogenous depression and the healthy controls.


CONCLUSIONS
Patients with whiplash showed a distinct pattern of trigger point distribution that differed significantly from other patient groups and healthy subjects. The semispinalis capitis muscle was more frequently affected by trigger points in patients with whiplash, whereas other neck and shoulder muscles and the masseter muscle did not differentiate between patients with whiplash and patients with nontraumatic chronic cervical syndrome or fibromyalgia.
Reha Rheinfelden Rehabilitation Center, Rheinfelden, Switzerland. th.ettlin@reha-rhf.ch
Thierry
T
Ettlin
Corina
C
Schuster
Robert
R
Stoffel
Andreas
A
Brüderlin
Udo
U
Kischka
D002574:Cervical Vertebrae / Q000293:injuries; D003430:Cross-Sectional Studies; D005356:Fibromyalgia; D006801:Humans; D009209:Myofascial Pain Syndromes / Q000209:etiology*; D016059:Range of Motion, Articular; D020069:Shoulder Pain / Q000209:etiology; D017695:Soft Tissue Injuries / Q000209:etiology; D014911:Whiplash Injuries / Q000150:complications* / Q000503:physiopathology