Foreman and Croft, in their wonderful text which has come to be recognized in the chiropractic community as perhaps the single definitive and authoritative text, contains a rather startling statement:
The tendency, then, for many practitioners is to refer to the condition (the classic symptomatology that follows a CAD, i.e. a cervical acceleration-deceleration injury, as a “chronic strain”, which is actually incongruous because strains heal in a few weeks.
Sprain/strain injuries heal in a few weeks??? Are the IME doctors that have sold their souls to the insurance industry actually right? No!!! Foreman and Croft say that, while the sprain/strain injury may heal, the whiplash injury victim is left chronic symptoms due to the chronicity of the injury to the facet (zygapophysial) joint, myofascial injury, and discogenic injuries (whether a new herniation or the aggravation of pre-existing degenerative disc disease).
Medical research has proven that 50-60% of whiplash victims have suffered a facet joint injury. See Lord et al (Lord SM, Barnsley L, Wallis BJ, Bogduk N. “Chronic cervical zygapophysial joint pain after whiplash: a placebo-controlled prevalence study”which was published in Spine 1996; 21(15):1737-1745).
Likewise, medical science has come to recognize that myofascial injury is a significant component of chronic and permanent whiplash injuries. Myofascial pain syndrome is now well recognized in the medical literature as a credible clinical entity-but not recognized by most doctors who do IME’s for insurance companies. The American Medical Association now teaches about the subject of Myofascial Pain Syndrome in its continuing medical education courses.
Similarly, discogenic pain syndrome has come to be recognized as a reliable clinical entity. It is now recognized in the medical literature that disc injury can cause significant pain even when the disc protrusion is not pressing on a nerve! Again, while the medical literature clearly establishes this concept, medical doctors doing IMEs for insurance companies have been slow to accept that fact.
