Chronic Pain in the Young: Post-Traumatic Neck Pain, Mechanism of Re-Injury

By | March 11, 2012

In the absence of external forces fibroblasts grow in a random amorphous pattern. When subject to tensile forces their growth pattern tends to align with the forces. Whether regular exercise can increase the strength of scar tissue is an area of ongoing research.

One of the most frequent questions I get from chronic neck pain patients at Schlesinger Pain Centers is to explain the causes of the periodic exacerbations of their pain. Most insist that there is no real history of recent trauma to account for the increased pain and in a way they may be right. After the original injury the muscles, tendons and ligaments in the neck attempt heal themselves, but the mature human body lacks the ability to regenerate these highly differentiated and specialized tissues so it repairs the torn muscles, tendons or ligaments by interposing amorphous scar tissue. The problem is that scar tissue is not nearly as strong. Studies of surgical wound healing suggest that this scar tissue is at most 50% as strong as the pieces of ligament that it is trying to reconnect. If we go back to our analysis of kinetic energy loads in yesterday’s blog we see that if a normal neck can withstand the force of 15 mile per hour crash a neck held together mainly with scar tissue may fail after a sudden deceleration of only 10 miles per hour. In some cases the patient need only turn their neck suddenly to one side to trigger an exacerbation of their chronic neck pain. This means that those suffering from chronic pain in the young are at risk from even riding in a car. The only real hope is to strengthen the normal tissues in the neck through yoga therapy and exercise.

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