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Persistent myalgia following whiplash.

Jan Dommerholt1

  • 1Pain & Rehabilitation Medicine, Bethesda, MD 20814-2432, USA. dommerholt@painpoints.com

Current Pain and Headache Reports
|September 15, 2005
PubMed
Summary

Persistent whiplash pain may stem from neurophysiologic changes like central sensitization, not just psychosocial factors. Myofascial trigger points and their chemical environment are key to understanding and managing this chronic pain.

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Area of Science:

  • Pain research
  • Neuroscience
  • Musculoskeletal disorders

Background:

  • Persistent myalgia after whiplash is often attributed to psychosocial factors.
  • Emerging evidence suggests neurophysiologic mechanisms, including sensitization, are involved.
  • Myofascial trigger points (MTPs) are implicated in maintaining pain sensitization.

Purpose of the Study:

  • To review the neurophysiologic mechanisms of persistent myalgia post-whiplash.
  • To highlight the role of central sensitization and MTPs in chronic whiplash pain.
  • To discuss the implications for differential diagnosis and patient management.

Main Methods:

  • Literature review of neurophysiologic mechanisms in whiplash-associated pain.
  • Analysis of the role of peripheral and central sensitization.
  • Examination of the contribution of myofascial trigger points and their chemical milieu.

Main Results:

  • Neurophysiologic mechanisms, particularly peripheral and central sensitization, are significant contributors to persistent myalgia.
  • Myofascial trigger points play a critical role in sustaining this sensitization.
  • The chemical environment within MTPs is an important factor in pain persistence.

Conclusions:

  • Persistent myalgia following whiplash warrants consideration of neurophysiologic mechanisms beyond psychosocial factors.
  • Central pain mechanisms and myofascial trigger points should be included in the differential diagnosis.
  • Integrating these findings into management strategies may improve outcomes for patients with chronic whiplash pain.

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