Wednesday, December 5, 2007

Acupuncture Applied to Treat Pain due to Whiplash Injuries

by Yemeng Chen, L. Ac., FICAE, President, New York College of Traditional Chinese Medicine

In our car-oriented society, whiplash injury cases are commonly seen in acupuncture practice. These patients typically have long-term physical and subjective symptoms for which acupuncture treatment is a useful modality.

1. Factors

According to 1994 estimates, upwards of 1 million people sustain whiplash-type injuries per year in United States. Of more than 11 million motor vehicle accidents that year, 2.6 million involved rear-end collisions in. Women (especially 20- to 40-year age group) have persistent neck pain more often than men, by a ratio of 7:3. (1)

Whiplash injury refers to neck injury, resulting from hyperextension followed by flexion that occurs when an occupant of a motor vehicle is hit from behind by another vehicle. Other terms have been used such as cervical sprain, cervical myofacial pain Syndrome, acceleration-deceleration injury, hyperextension injury and soft tissue cervical hyperextension injury. (2)

One study (3) showed the ten most-reported symptoms with their estimated prevalence: neck pain (97%), headache (97%), TMJ (82%), Shoulder pain (65%), anxiety (55%), back pain (42%), depression (41%), visual symptoms (blurred vision) (35%), and dizziness (23%). The clinical features of whiplash injury include myofascial injury (cervical strain, muscle tears, and/or rupture of ligaments), cervical disc herniation, cervical spine fracture and cervical facet-joint injury. Acupuncture has demonstrated a significant therapeutic effect on myofascial injuries.

Long-term, positive outcomes of whiplash injury are elusive. One clinical trial (4) showed the percentage of patients with residual pain: 44% had pain at three months, 30% at six months, 24% at twelve months, and 18% at two years. But only 4% of the patients were considered disabled at two years. If the head was inclined or rotated at the time of collision, patients were more likely to have pain at a two-year follow-up. A history of pre-traumatic headache predicted a worse outcome. Patients with long-term symptoms were more likely to have radicular symptoms, anxiety, sleep disturbance, and blurred vision.

2. Therapeutic Effect of Acupuncture

Although whiplash injury patients are commonly seen in acupuncture clinics, only a few clinical trials and research projects has been conducted. Greenwood, et al, reported that 25 patients with whiplash injury, most of whom had twelve treatments at twice weekly intervals. Improvement was noted in 84% of patients. Observed phenomena included myoclonic jerking, emotional releases and regression. (5) Rabl V, et al, had a trial with 153 patients suffering from pain, edematous conditions, and impaired movement following traumas sustained in accidents who were treated or “after-treated” with acupuncture. With a standardized acupuncture program, the improvement was significant in all nine groups Acupuncture also proved itself to be an effective form of therapy for after-treatment. (6) Ayuzawa S, et al, reported that the Bi-Digital O-Ring test successfully used in the diagnosis and treatment for patients with pain after whiplash injury. (7) Hertz H, et al, treated 30 whiplash injury patients with auricular acupuncture, demonstrating its effectiveness as a form of therapy for treatment of accident patients with whiplash. (8) Fattori B, et al, had a trial of 15 patients with a control group of balance disorders following whiplash injury, and observed a significant difference between the two groups regarding the reduction of the CER (closed eyes with retroflexed head) length of the statokenisigram. (9) Recently, Fattori, et al, (10) had a further study with 27 patients with a control group of 25 patients, who were treated with a non-steroidal anti-inflammatory drug and myorelaxation or with physiotherapy only. [read more]

1 comment:

Anonymous said...

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