I often have patients present to my office with complaints of chronic headache and/or neck pain. History reveals that many of them have undergone a whiplash or other neck injury in the recent or even very distant past "“ sometimes more than 40 years before they present to my office. The vast majority have been to a variety of doctors and chiropractors with no relief "“ or at least no lasting relief "“ of their pain. Most have also tried a huge assortment of pain-relieving medications without substantial benefit.
I recently discussed several causes for chronic pain after a "?whiplash' injury. One of the causes mentioned, overstretching of ligaments and tendons of the neck, is actually fairly easy to diagnose in many cases and may be fairly easy to treat. Despite this, many physicians are unaware of the cause, how to diagnose it, and how to treat it with a simple procedure called Prolotherapy.
In many cases, as stated in my prior blog, no damage is visible on X-rays, MRIs, or CAT scans. Even worse, sometimes damage such as arthritis shows up and provides a plausible, but incorrect, explanation for the pain "“ but, we'll tackle that in next month's blog. The point is that the lack of radiologic evidence for injury means most doctors have no explanation for the ongoing pain.
If such a patient's only complaint was pain around the eye, for instance, almost every doctor I know would diagnose it as "?chronic sinusitis' "“ in many cases even after X-rays show no evidence of inflamed sinus tissues and antibiotics fail to stop the pain. If the doctors:
- understood the referral patterns of pain from ligaments and tendons in the neck region;
- knew a simple test to find out if these ligaments and tendons were injured, and;
- knew how to get the body to fix those ligaments and tendons;
many of these patients might be cured of their pain.
The test couldn't be simpler. Most of these patients will show point-tenderness (that they didn't even know they had!) if the doctor presses with his or her finger over the ligament and tendon attachments of the neck. In some of these cases, pressing on these points may even reproduce the EXACT headache pain the patient normally experiences.
Knowing the SOURCE of the pain allows the physician to determine proper treatment. Personally, I and many of my colleagues have had substantial success treating such injuries with Prolotherapy. The treatment is even used for chronic pain disorders at the famed Mayo Clinic, though at least some of their practitioners agree that it is most effective if used in combination, as I use it, with manipulative medicine.
A physician who understands these principles, such as an osteopathic manual medicine practitioner or prolotherapy practitioner, may be able to help with these problems when others cannot.
Dr. Cohn is employed at the Born Preventive Health Clinic in Grand Rapids, Michigan, where he is focused on treating acute/chronic pain and injury via osteopathic manipulation and prolotherapy. Dr. Cohn regularly blogs on medical issues and other issues of global and personal interest.