The Prevalence of Chronic Cervical Zygapophysial Joint Pain After Whiplash

Barnsley, Leslie; Lord, Susan M.; Wallis, Barbara J.; Bogduk, Nikolai

doi:10.1097/00007632-199501000-00004

Cited by 471 publications

(263 citation statements)

References 21 publications

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“…Zygapophyseal joint pain has been suggested as the single most-common basis for chronic neck pain and it might be responsible for many of the headaches. 24 The Cervicogenic Headache International Study Group concluded that headache arising from the upper part of the neck is one of the three major criteria for the diagnosis, 25 a finding that could have consequences for treatment modalities in general practice and can be implemented in routine examination after an MVA.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Impact of motor vehicle accidents on neck pain and disability in general practice

Vos¹,

Verhagen²,

Passchier³

et al. 2008

Br J Gen Pract

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BackgroundHigh levels of continuous neck pain after a motor vehicle accident (MVA) are reported in cross-sectional studies. Knowledge of this association in general practice is limited. AimTo compare the differences in perceived pain and disability in patients with acute neck pain due to an MVA versus other self-reported causes. The secondary aim was to identify prognostic factors for continuous neck pain. Design of studyProspective cohort study with 1-year follow-up. SettingGeneral practices in Rotterdam and its suburban region. MethodPatients with non-specific acute neck pain were invited to participate. Questionnaires were collected at baseline and after 6, 12, 26, and 52 weeks. The numerical pain-rating scale (NRS) and the neck disability index (NDI) were measured. Regression analysis was used to identify prognostic factors for continuous neck pain. ResultsA total of 187 patients were included. The MVA subgroup (n = 42) was significantly younger (P = 0.007), reported more sick leave (P = 0.037), higher levels of headache (P<0.001) and higher NDI scores at baseline (P = 0.018) but lower scores for previous neck pain (P = 0.015) compared to the remaining cohort. At follow-up the MVA subgroup had higher scores for continuous neck pain (63% versus 40%) and at the NDI (11.0 versus 7.1). After multivariate analysis 'pain in the upper part of the neck' (odds ratio [OR] = 1.6), 'duration of complaints at baseline longer than 2 weeks' (OR = 5.3), and an 'MVA' (OR = 5.3) were significantly correlated with outcome. ConclusionIndividuals exposed to MVAs constitute a relevant subgroup of patients with neck pain. An MVA and a longer duration of complaints are prognostic factors for continuous neck pain.

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Section: Comparison With Existing Literaturementioning

confidence: 99%

Impact of motor vehicle accidents on neck pain and disability in general practice

Vos¹,

Verhagen²,

Passchier³

et al. 2008

Br J Gen Pract

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“…In clinical studies of patients reporting painful neck injury, the facet joint has been identified in 25-62% of cases as the site of pain (Aprill and Bogduk, 1992;Barnsley et al, 1994), with the C5-C7 spinal levels being the most commonly reported site of injury in whiplash (Barnsley et al, 1995;Bogduk and Marsland, 1998). Histologic studies of rabbit, rat, and cadaveric human tissue have identified nociceptive nerve fibers throughout the structures of the facet joint, including the joint's capsular ligament (Giles and Harvey, 1987;McLain, 1994;Cavanaugh et al, 1996;Inami et al, 2001;Ohtori et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

A novel rodent neck pain model of facet-mediated behavioral hypersensitivity: implications for persistent pain and whiplash injury

Lee

Thinnes

Gokhin

et al. 2004

Journal of Neuroscience Methods

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. (2004). A novel rodent neck pain model of facet-mediated behavioral hypersensitivity: implications for persistent pain and whiplash injury. Retrieved from http://repository.upenn.edu/be_papers/43 A novel rodent neck pain model of facet-mediated behavioral hypersensitivity: implications for persistent pain and whiplash injury Abstract Clinical, epidemiological, and biomechanical studies suggest involvement of cervical facet joint injuries in neck pain. While bony motions can cause injurious tensile facet joint loading, it remains speculative whether such injuries initiate pain. There is currently a paucity of data explicitly investigating the relationship between facet mechanics and pain physiology. A rodent model of tensile facet joint injury has been developed using a customized loading device to apply 2 separate tensile deformations (low, high; n=5 each) across the C6/C7 joint, or sham (n=6) with device attachment only. Microforceps were rigidly coupled to the vertebrae for distraction and joint motions tracked in vivo. Forepaw mechanical allodynia was measured postoperatively for 7 days as an indicator of behavioral sensitivity. Joint strains for high (33.6±3.1%) were significantly elevated (p<0.005) over low (11.1±2.3%). Digitization errors (0.17±0.20%) in locating bony markers were small compared to measured strains. Allodynia was significantly elevated for high over low and sham for all postoperative days. However, allodynia for low injury was not different than sham. A greater than three-fold increase in total allodynia resulted for high compared to low, corresponding to the three-fold difference in injury strain. Findings demonstrate tensile facet joint loading produces behavioral sensitivity that varies in magnitude according to injury severity. These results suggest that a facet joint tensile strain threshold may exist above which pain symptoms result. Continued investigation into the relationship between injury mechanics and nociceptive physiology will strengthen insight into painful facet injury mechanisms. for high compared to low, corresponding to the three-fold difference in injury strain.Findings demonstrate tensile facet joint loading produces behavioral sensitivity that varies in magnitude according to injury severity. These results suggest that a facet joint tensile strain threshold may exist above which pain symptoms result. Continued investigation into the relationship between injury mechanics and nociceptive physiology will strengthen insight into painful facet injury mechanisms.

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“…Based on evaluations utilizing controlled diagnostic blocks, the prevalence of zygapophysial or facet joint involvement has been estimated to be between 15% to 45% in heterogeneous groups of patients with chronic low back pain [24][25][26][27][28] and 36% to 67% in patients with chronic neck pain. [29][30][31] However, false-positive rates varying from 27% to 63% in the cervical spine and 17% to 50% in the lumbar spine have also been described.…”

Section: -9mentioning

confidence: 99%