Cervical Lecture 3: Whiplash-Associated Disorders (WAD) and Neck Pain with Headache (CGH)

Practice flashcards covering the classification, prognosis, evaluation, and treatment of Whiplash-Associated Disorders (WAD) and Cervicogenic Headaches (CGH) based on lecture notes.

Whiplash

An injury to the neck caused by sudden acceleration-deceleration forces, typically compared to the cracking of a whip.

Whiplash-Associated Disorders (WAD)

A term describing the sequelae or symptoms following a whiplash mechanism of injury.

QTF WAD Grade 0

Classification where the patient has no symptoms of neck pain and no physical signs.

QTF WAD Grade I

Classification where the patient has subjective symptoms of neck pain, stiffness, or tenderness, but no physical signs.

QTF WAD Grade II

Classification where the patient has neck symptoms and musculoskeletal physical signs, including decreased ROM and point tenderness.

QTF WAD Grade III

Classification where the patient has neck symptoms and neurologic signs, including decreased or absent DTRs, muscle weakness, and sensory deficits.

QTF WAD Grade IV

Classification where the patient has neck symptoms along with a fracture or dislocation.

Sterling WAD Sub-classification II-A

Includes neck pain, motor impairment, decreased ROM, and altered muscle recruitment patterns (CCFT).

Sterling WAD Sub-classification II-B

Includes II-A criteria plus sensory impairment (local cervical mechanical hyperalgesia) and psychological impairment/elevated psychological distress.

Sterling WAD Sub-classification II-C

Includes II-B criteria plus increased joint positioning errors, generalized hypersensitivity to mechanical/thermal stimuli, potential SNS disturbances, and elevated levels of post-traumatic stress.

Joint Position Error (JPE) Testing Formula

The calculation used to find the degree of error: $\tan^{-1}(\text{error distance}/90)$, where measuring occurs $90\,\text{cm}$ from the wall.

Abnormal JPE Threshold

A degree of error greater than $4.5^{\circ}$ is considered abnormal.

Cervicogenic Headache (CGH)

A headache arising from musculoskeletal dysfunction of the cervical spine, especially the upper cervical spine, affecting women four times as much as men.

CGH Mechanism

Referred pain resulting from the convergence of afferent input from nociceptive source regions and referred symptom regions, or direct irritation of C2 or C3 nerve roots.

Cervical Flexion Rotation (CFR) Test

An exam finding used to identify upper cervical ($C1-C2$) segmental mobility deficits in patients with CGH.

CGH Pain Characteristics

Pain that is moderate-to-severe, nonthrobbing, and nonlancinating, usually starting in the neck.

Prognostic Factor: NDI

A baseline Neck Disability Index (NDI) score greater than $29\%$ is predictive of poor recovery in WAD.

Prognostic Factor: Baseline Pain

A baseline pain level greater than $5.5/10$ is predictive of poor recovery in WAD.