Resolution of whiplash-associated allodynia following cervicothoracic thrust and non-thrust manipulation.
Whiplash injuries of the cervical spine comprise 30% of injuries reported following motor vehicle accident (MVA) and often progress to chronic painful conditions. The purpose of this case report is to describe the management of a 37-year-old female referred to physical therapy with neck and shoulder pain after whiplash injury. The patient demonstrated limited cervical and shoulder active range of motion as well as quantitative sensory testing (QST) results consistent with central nervous system sensitization. She was treated for 11 visits over a 6-week period with manual therapy and specific exercise directed to the cervicothoracic spine. Her pain decreased from 9/10 to 2/10 by the end of treatment and remained improved at 1/10 at the 6-month follow-up. Her Copenhagen Neck Functional Disability Scale decreased from 23/30 to 4/30 by the 11th visit. In addition, she demonstrated clinically significant increases in cervical active range of motion and normal somatosensation. Manual therapy of the cervicothoracic spine may be a beneficial adjunct to the standard care of patients with signs and symptoms of central sensitization after whiplash-associated disorder and primary report of neck and shoulder pain.
St. John Medical Center, Tulsa, OK, USA. carina.lowry@hotmail.com
Carina D
CD
Lowry
Michael A
MA
O'Hearn
Carol A
CA
Courtney
D000063:Accidents, Traffic; D000328:Adult; D001268:Atlanto-Axial Joint / Q000503:physiopathology; D001269:Atlanto-Occipital Joint / Q000503:physiopathology; D002574:Cervical Vertebrae / Q000503:physiopathology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D026201:Musculoskeletal Manipulations; D019547:Neck Pain / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D010147:Pain Measurement; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012720:Severity of Illness Index; D012785:Shoulder Joint / Q000503:physiopathology*; D020069:Shoulder Pain / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D013904:Thoracic Vertebrae / Q000503:physiopathology*; D013997:Time Factors; D016896:Treatment Outcome; D014911:Whiplash Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*