Whiplash associated disorders: A prospective investigation of the effects of cervical medial branch radiofrequency neurotomy on sensory, motor and psychological Features

Abstract

Whiplash injury results in persistent pain and disability for a significant number of individuals. Clinically, these individuals present with a complex presentation of physical features (including central hyperexcitability and motor dysfunction) and psychological manifestations (e.g. psychological distress, pain catastrophization and posttraumatic stress symptoms) that may be resistant to conservative care. Understanding this complex symptom presentation is made challenging by the inability of current diagnostic imaging techniques to clearly identify potential pathoanatomical causes for these symptoms. Nevertheless, anatomical structures contributing to chronic whiplash associated disorders (WAD) have been identified in clinical and basic science research. These results provide further knowledge of processes underlying chronic WAD. The finding that peripheral nociception is one of the drivers of central hyperexcitability, motor dysfunction and psychological manifestations in chronic WAD is a vital step forward towards more effective management for this difficult patient group, allowing healthcare providers to provide patients with appropriate treatment options, especially when conservative therapy has failed.