Neck Pain | Sunday Observer

Neck Pain

3 January, 2021

Neck pain is a common pain condition in the spine. Patients experiencing neck pain visit pain clinics for treatment, especially in the west as the pain clinics are well established.

The common causes of neck pain are:

1. Whiplash injury

2. Cervical spondylosis

3. Facet joint arthropathy

4. Disc problems

5. Trauma

6. Muscle spasms

Whiplash Injury

Whiplash is a neck injury due to forceful movement of the neck, like the cracking of a whip. The neck movements are mainly forwards and backwards. Sudden movement can damage the vertebrae, discs, ligaments and neck muscles.

It is commonly caused by back-end car accidents, such as, a vehicle hit from behind. The driver and the passengers of both vehicles could end up with a whip lash injury. The higher the impact more the symptoms and signs of whiplash. In the UK there are increased motor insurance claims due to whiplash injury. Usually, the claimant is referred to a consultant by the insurer (neuro, spinal orthopaedics or pain consultants) for a medical report. Treating these patients are challenging as there are claims involved.

Whiplash injuries can also occur in sports such as rugby, kick boxing, boxing and football. It could also result from physical abuse and other types of traumas, such as a fall. Whiplash may be called a neck sprain or strain, but these terms also include other types of neck injuries.

Most people with whiplash get better within a few weeks with pain medication and exercise. However, some people may end up with chronic neck pain and other long-lasting problems.

The goals of whiplash treatment are to:

• Control the pain

• Restore normal range of movement

• Get back to normal activities

Symptoms and signs

Signs and symptoms of whiplash usually develop within days of the injury, and may include:

• Neck pain and stiffness

• Worsening of pain with neck movement

• Loss of range of motion in the neck

• Headaches

• Tenderness or pain in the neck

• Tingling or numbness in the arms

• Fatigue

• Dizziness

• Blurred vision

• Ringing in the ears (tinnitus)

• Sleep disturbances

• Irritability

• Difficulty concentrating

• Memory problems

• Depression


• Physical Examination

• X ray - Fractures, Dislocations

• CT scan - Damage to vertebral body

• MRI scan - Damage to soft tissue, discs, ligaments.

Pain management

• Heat or cold. Either heat or cold towel

• Couple of days rest

• Simple Analgesics

• Strong Analgesics

• Muscle relaxants

• Short term soft collar

• Physiotherapy and acupuncture

• Facet joint injections

X ray of a patient with a whiplash injury. Patient has cervical spondylosis as well. Pointer is in the facet joint.

When to see a Pain Consultant

A Pain Consultant should be seen for any neck pain or other whiplash symptoms after a car accident, sports injury or other traumatic injury. It is important to get a prompt and accurate diagnosis and to rule out broken bones or other damage that can cause or worsen symptoms.


Most people who have whiplash feel better within a few weeks and don’t seem to have any lasting effects from the injury. However, some people may continue to have pain for several months or years after the injury occurred. It can be debilitating.

It is difficult to predict how each person with whiplash may recover. Generally, you may be more likely to have chronic pain if your first symptoms were intense, started rapidly and included:

• Severe neck pain

• More-limited range of motion

• Pain that spread to the arms

The following risk factors have been linked to a worse outcome:

• Having had whiplash before

• Older age

• Existing low back or neck pain

• A high velocity accident

 Dr Namal Senasinghe MBBS, Dip in Pain Med, FFARCS, FFPMCA, CCST(U.K) is a Consultant in pain medicine at the ‘London Pain Management Centre’ No 31, Horton Place, Colombo 7, Sri Lanka (hotline 0767155716). Dr Senasinghe has 25 years experience as a doctor in the UK of which 18 years are as a Consultant in pain medicine for the NHS UK.

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