SERIOUS INJURIES - Soft Tissue Injuries

Soft Tissue Injuries - Because the neck is so flexible and because it supports the head, it is extremely vulnerable to injury. Motor vehicle or diving accidents, and falls may result in neck injury. The regular use of safety belts in motor vehicles can help to prevent or minimize neck injury. A "rear end" automobile collision may result in hyperextension, a backward motion of the neck beyond normal limits, or hyperflexion, a forward motion of the neck beyond normal limits. The most common neck injuries involve the soft tissues: the muscles and ligaments. Severe neck injuries with a fracture or dislocation of the neck may damage the spinal cord and cause paralysis.

If severe neck pain occurs following an injury (motor vehicle accident, or fall), medical care should be sought immediately. A chiropractor or orthopedist specialize in neck injuries.

Their treatment may consist of one or more of the following procedures:

• A physical examination consisting of an evaluation of neck motion, neck tenderness, and the function of the nerves and muscles in your arms and legs,
• X-rays,
• MRI (magnetic resonance imaging). This non x-ray study allows an evaluation of the spinal cord and nerve roots,
• CT (computed tomography),
• This specialized x-ray study allows careful evaluation of the bone and spinal canal,
• Myelography (injection of a dye or contrast material into the spinal canal). This specific x-ray study also allows careful evaluation of the spinal canal and nerve roots,
• EMG (electromyography). This test evaluates nerve and muscle function.

How neck pain is treated depends on what the diagnosis reveals. However, most patients are treated successfully with rest, medication, immobilization, physical therapy, exercise, activity modifications, or a combination of these methods.

When neck pain persists or is chronic, your orthopaedist may recommend a rehabilitation program that includes an exercise program and various types of physical therapy to help you relieve your pain and prevent it from coming back.

If conservative measures do not help, surgery may be necessary to reduce pressure on the spinal cord or a nerve root when pain is caused by a herniated disc or bony narrowing of the spinal canal. Surgery may also be required following an injury to stabilize the neck and minimize the possibility of paralysis, such as when a fracture results in instability of the neck.

INJECTIONS - The most commonly used injections are local anesthetic and/or steroids. They are usually given either in the area that is believed to be the source of the pain, such as into a muscle or facet joint, or around the nerves of the spine (an epidural or nerve root injection). Injections are occasionally placed into the disc, but this is done far less frequently.

Exercise and Stretching - Exercising to restore motion and strength to a painful lumbar spine can be very helpful in relieving pain. Although there is controversy as to which are the most effective spine exercises, it is generally agreed that exercise should be both aerobic and specific to the spine.