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Myofascial-entheseal dysfunction in chronic whiplash injury: an observational study
1Consultant Orthopaedic Surgeon , The Wellington Hospital , London NW8 9LE , UK.
Objectives:
To document any consistent clinical findings in a large cohort of patients with whiplash associated disorder.
Design:
Four-year observational study.
Setting:
Large orthopaedic medicolegal practice in the UK.
Participants:
1025 consecutive cases of chronic whiplash associated disorder.
Main Outcome Measures:
OBSERVATIONAL STUDY OF THE CLINICAL FEATURES OF WHIPLASH ASSOCIATED DISORDER: detailed examination
Results:
THREE CONSISTENT CLINICAL FEATURES: neck pain; reduced cervical spine range of motion; and myofascial-entheseal dysfunction. With regards to the myofascial-entheseal dysfunction there were trigger points in the upper, middle or lower trapezius; with or without enthesopathy in the lower or middle trapezius.
Conclusions:
On the basis of this large observational experience we propose a clinically-based definition of chronic whiplash associated disorder: a painful syndrome following acceleration-deceleration injury with neck stiffness; and myofascial-entheseal dysfunction.
