Research

Chronic Pain Among Whiplash Injuries Predicted With MRI

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Up to 25% of whiplash patients are said to be affected by long-term pain and disability as a result of whiplash-related injury. Identifying the probability of these potential long-term effects may have just become easier, however, with special MRI technology begin evaluated by Northwestern Medicine.

The MRI protocol being used at Northwestern reportedly catches hints of the potential to develop chronic pain within 2 weeks or less of initial injury. The protocol aims to enable faster and more specialized treatment, which could be particularly beneficial for the PTSD.

According to a media release from Northwestern, Northwestern scientists found unusual muscular changes in the chronic pain group using a sophisticated MRI that measures the fat/water ratio in the muscles. The imaging revealed large amounts of fat infiltrating the patients’ neck muscles, indicating rapid atrophy.

“We believe this represents an injury that is more severe than what might be expected from a typical low-speed car crash,” says lead investigator James Elliott, assistant professor of physical therapy and human movement sciences at Northwestern University Feinberg school of Medicine. The study appears in Spine.

The findings reportedly help physicians understand water/fat MRI, in tandem with other clinical signs/symptoms can be used to identify who is likely to develop post-traumatic stress disorder. This then could be used to justify the referral of the patient to a psychiatrist or psychologist, Elliott said.  PTSD is a disorder caused by experiencing or witnessing a traumatic event.

“These patients have shown to not respond well to traditional rehabilitation such as physical therapy,” Elliott said. “It appears that they may require a more concerted effort for pain management from their physician and help from a psychologist.” Emerging, yet preliminary evidence suggests this to be a reasonable strategy.

A small preliminary study previously done by Elliott and Northwestern colleagues shows whiplash victims with chronic pain also have a high level of muscle fat in their lower legs, indicating muscle atrophy.

Elliott hypothesizes these patients may have partially damaged their spinal cord. They reported feeling fatigued and clumsy when walking and weakness in their legs, with difficulty pushing hard on the gas pedal of a car or standing on their tiptoes

[Source: Northwestern Medicine]