Nebel K, Stude P, Lüdecke C, Wiese H, Diener H-C, Keidel M
Department of Neurology, University of Essen, Essen, Germany.
Cephalalgia. 2005 Mar;25(3):205-13. doi: 10.1111/j.1468-2982.2004.00842.x.
Cervical pain is a prominent symptom in both acute whiplash injury and late whiplash syndrome. However, no systematic analysis of post-traumatic pain development covering several weeks has yet been performed in whiplash patients. It was the aim of the present study to analyse the duration and course of post-traumatic muscle pain due to whiplash injury in a prospective follow-up examination with short investigation intervals. A recovery of initially increased muscle pain after whiplash injury within 1 month was hypothesized. Pressure pain of the splenius and trapezius muscles was recorded using PC-interactive pressure algesimetry. Whiplash patients were investigated during the acute injury stage and after 3, 4, and 6 weeks and compared with matched controls. We found significantly increased pressure pain of the splenius and trapezius muscles in the acute stage of whiplash injury. After 4 weeks patients' scores of pain parameters were comparable to those of healthy control subjects. Within the patient group the first changes of pressure pain were observed within 3 (splenius) and 4 weeks (trapezius). For most patients the recovery dynamics lasted 4-6 weeks. A minority of patients did not show any improvement after 6 weeks. The present study shows that the dynamics of pressure pain due to whiplash injury can be quantified by means of PC-interactive pressure algesimetry. Our results confirm the clinical experience that the acute post-traumatic cervical syndrome normally subsides within weeks.
颈部疼痛是急性挥鞭样损伤和晚期挥鞭样综合征的一个突出症状。然而,尚未对挥鞭样损伤患者进行过涵盖数周的创伤后疼痛发展的系统分析。本研究的目的是在短调查间隔的前瞻性随访检查中,分析挥鞭样损伤所致创伤后肌肉疼痛的持续时间和过程。我们假设挥鞭样损伤后最初增加的肌肉疼痛会在1个月内恢复。使用PC交互式压力痛觉测定法记录斜方肌和夹肌的压痛。在急性损伤期以及3周、4周和6周后对挥鞭样损伤患者进行调查,并与匹配的对照组进行比较。我们发现,在挥鞭样损伤的急性期,斜方肌和夹肌的压痛显著增加。4周后,患者的疼痛参数评分与健康对照受试者相当。在患者组中,压痛的首次变化在3周(夹肌)和4周(斜方肌)内观察到。对于大多数患者来说,恢复动态持续4至6周。少数患者在6周后没有任何改善。本研究表明,挥鞭样损伤所致压痛的动态变化可以通过PC交互式压力痛觉测定法进行量化。我们的结果证实了临床经验,即急性创伤后颈部综合征通常在数周内消退。