Whiplash: same elephant, different room.

摘要: Musculoskeletal injury can cause acute pain and also trigger chronic pain. The mechanisms resulting in these 2 outcomes are essentially different, with relating primarily to peripheral nociception central sensitization. Acute musculoskeletal usually resolves time or treatment. Chronic pain, by definition, persists associates significant longterm health effects diminished quality of life (QOL). Despite the importance this problem, issues surrounding persisting after remain controversial1. Aspects postinjury disability addressed issue Journal through followup persons involved minor trauma from motor vehicle accidents2. The clinical features patients trauma, where inciting lesion has resolved, distinctive embody a number characteristic phenotypes. Central sensitization is most prominent contributing mechanism3. Common examples fibromyalgia (FM), regional syndrome, complex syndrome (CRPS)4. These disorders characterized widespread regionalized distribution that cannot be explained an abnormality specific localized neural structure, it periphery spinal area. may segmental often accompanied unpleasant non-neuroanatomical sensory sensations within same region. There lowering threshold elicited clinically determination abnormal tenderness on palpation, more selected areas known as tender points. Muscular tightness, co-contraction, development points common. mild soft tissue swelling dermatographia, indicative neurogenic inflammation. In CRPS vasomotor, sudomotor, muscle, dystrophic present5. In addition physical signs, complain varying degree about sleep disturbance, fatigue, cognitive dysfunction, … Address correspondence Dr. Littlejohn, Suite H, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria, Australia; E-mail: Geoff.littlejohn{at}monash.edu