Myofascial-entheseal dysfunction in chronic whiplash injury: an observational study.

OBJECTIVES

To document any consistent clinical findings in a large cohort of patients with whiplash associated disorder.

DESIGN

Four-year observational study.

SETTING

Large orthopaedic medicolegal practice in the UK.

PARTICIPANTS

1025 consecutive cases of chronic whiplash associated disorder.

MAIN OUTCOME MEASURES: OBSERVATIONAL STUDY OF THE CLINICAL FEATURES OF WHIPLASH ASSOCIATED DISORDER: detailed examination

RESULTS

THREE CONSISTENT CLINICAL FEATURES: neck pain; reduced cervical spine range of motion; and myofascial-entheseal dysfunction. With regards to the myofascial-entheseal dysfunction there were trigger points in the upper, middle or lower trapezius; with or without enthesopathy in the lower or middle trapezius.

CONCLUSIONS

On the basis of this large observational experience we propose a clinically-based definition of chronic whiplash associated disorder: a painful syndrome following acceleration-deceleration injury with neck stiffness; and myofascial-entheseal dysfunction.