Whiplash
Most whiplash patients show neck complaints associated with a variety of signs, like decreased range of motion, muscular point tenderness, headache, memory loss, dizziness, etcetera. Symptoms worsen over time, not infrequently after an asymptomatic interval.
Uncontrolled trials suggest that multimodal rehabilitation programs result in improved overall function. Based on the degrees of evidence, the following treatments can be recommended: early physical activity in acute whiplash-associated disorders, radiofrequency neurotomy, combination of cognitive behavioral therapy with physical therapy interventions, and coordination exercise therapy in chronic whiplash-associated disorders. When using biotherapeutic injections, both cervical muscles and ligaments should be addressed.
Case
A family physician, 28, showed severe neck pain since she had a whiplash during a car accident. Especially, extension of the neck was very painful. On clinical examination, several painful spots (MPPs) and myogeloses (MGs) could be identified in the dorsal musculature and in the trapezius muscles, both on the left and right side.
I injected Zeel (2 ml, mixed with 4 ml lidocaine 0.3%) intramuscularly in the pain zones once a week. These injections were given in both trapezius muscles while the patient was lying on her stomach, with both hands under her forehead. Although she was improving after a few treatments, she complained that after each session the pain worsened considerably for about a day (reaction phase). I therefore changed the cocktail into 1 ml of Zeel, mixed with 5 ml lidocaine 0.3%. Such a ‘diluted' cocktail was less painful during injection and – more important – also gave her less reaction phases the next day. She obviously was the “sensitive type” of patient regarding these injections (during the biopuncture training, the importance of recognising such patients is explained to the physicians who attend the course).
Later on, I also started to give her injections into the myogeloses we found in the dorsal region. We continued the treatment on a regular basis (approx. 2 to 4 times a month), until she showed about an 80% recovery. Three months later, her neck pain reoccurred, although not as severe as the first time. Three injections with the same cocktail were enough to get her neck muscles back to normal, without taking any painkillers.
Case:
A young man, aged 24, came to see me for neck pain he had had for about ten days. He complained of pain in the neck, the left trapezius region and the left deltoid region. The pain came up a few days after a minor trauma (car accident), two weeks earlier. He was not diagnosed as having a whiplash associated disorder, because it was not clear if the pain was really due to the car accident. Oral non-steroidal anti-inflammatory drugs (NSAIDs) and physical therapy did not change the pain. X-rays of the neck was normal, MRI showed a hernia between C3 and C4 (mediolateral left).
He received injections with Gelsemium-Homaccord in the region of the pain, especially in the trapezius and deltoid muscles (fig. 32). These injections were given three times a week. On each occasion, he also received injections with lidocaine 0.5% in two myofascial trigger points. He also received Gelsemium-Homaccord orally, 4 times 10 drops a day. During the first week, the day after each session of injections, his pain got worse. The second week he was feeling progressively better. He was without any pain after two weeks of this treatment, and did not relapse (last check-up: six months later). I told him that early treatment with biopuncture possibly prevented the pain from becoming chronic.
For illustration of injection sites:
see “Biopuncture in General Practice: Fig. 32 p. 88
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