Week 3: WAD Pain Control Classification Flashcards
What causes whiplash?
Abnormal acceleration/deceleration of head, neck, and torso
What structures can be damaged as a result of whiplash?
- Facets
- Muscles
- DRG
- Ligaments
- Bones
- Brainstem
- Vascular
- Discs
What percentage of individuals continue to have long-term pain after whiplash?
25-50%
Signs/symptoms associated w/ WAD
- Pain and stiffness
- Headache
- Tinnitus
- Allodynia- thermal and mechanical
- Hyperalgesia
- Voice deficits
- Depression and anxiety
Predictors of poor outcome for WAD
- High initial pain and disability
- Age
- Gender
- Restricted neck movement
- Moderate levels of acute post-traumatic stress
- Cold hyperalgesia
Psychological factors relevant to WAD
- Pain catastrophising
- Fear of movement
- Lower pain self efficacy
- Distress
- Coping strategies
- Post-traumatic stress symptoms
What is the impact event scale?
A series of questions indicating the impact of the trauma
Psychological reaction to trauma cycle
Traumatic injury |
v v
Event distress Pain distress
| |
v v
Disability
What muscle changes might we see in patients w/ WAD?
Fatty deposits
What is the first step in managing patients w/ WAD?
- Questionnaires
- Physical exam
What questionnaires will we use with patients w/ WAD?
- Neck disability index (NDI)
- Impact events scale
What components of the physical exam will we focus on for patients w/ WAD?
- Range of movement
- Temperature threshold testing (cold pain threshold)
Management of milder symptom group for WAD
- Early intervention
- Specific rehab of motor deficits
- Psychological support
Management of moderate/severe symptom group for WAD
- Reassurance + ROM + strengthening
- Kinesthetic training
- Balance
- Eye movements
- Gaze stability training
- Co-ordination training
- Manual therapy
Joint position error and WAD
Look for:
- Jery movement
- Searching
- Dizziness
- Overshooting
- Movement patterns
