Onset of pain in the neck may be sudden, as in direct trauma to the head or neck (accidental or by design), or whiplash injury (karate or motor vehicle accident). Or it may be insidious, as in a high proportion of cases. In the sudden-onset group the preferred management is usually clear, except in the very low degree whiplash injury where, after rigorous assessment, it may prove useful to employ light cervical traction or very gentle manipulation. The insidious-onset group demands the same degree of rigour in assessment, in history taking, in main-line orthopaedic and neurological examination, and in local examination. Chronic whiplash injury that has not responded to other treatments may be considered for traction or vertebral manipulation — in the presence of abnormal local signs and in the absence of contraindications.
KeywordsNeck Pain Motor Vehicle Accident Whiplash Injury Polymyalgia Rheumatica Rigorous Assessment
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