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Auto Accidents and Sports Injuries can cause Neck Pain, Upper Back Pain, Shoulder Pain and Thoracic Outlet Syndrome

Research suggests that thoracic outlet syndrome most frequently occurs following a single episode of neck trauma such as a sports injury.

Research suggests that thoracic outlet syndrome most frequently occurs following a single episode of neck trauma, such as a motor vehicle accident (1). Motor vehicle accidents resulting in whiplash are the most common causes of neck injuries with approximately 1,000,000 per year in the US.

Motor vehicle accidents resulting in whiplash are the most common causes of neck injuries with approximately 1,000,000 per year in the United States (3).

An acute injury of the muscles and joints will stimulate the receptors in the joints to alert the brain that there is an injury. The brain will then respond with a sustained, tonic, protective reflex muscle spasm that will cause compression forces on the neck, back, and shoulder. These muscle spasms cause progressive narrowing of your thoracic outlet.

Quite often, injured car accident individuals had stopped for a red traffic light, when another vehicle hit them from behind. A force like this hyperextends the neck and stretches the scalenus muscles. These muscles stretch, bleed, hypertrophy, and shorten. This process further narrows the already crowded triangular tunnel through which the neurovascular bundle passes (2).

Injuries like this, especially a blow or jerking injury to the region of the neck or shoulder, can cause a chronic muscle spasm—which might precipitate the syndrome (4). This can occur even with minor impacts during car accidents (5). By the way, according to statistics, persistent neck pain is more common in women than men by a ratio of 70:30. (2)

Acute (Whiplash) vs. Chronic Causes

I’ve found that patients with whiplash show a distinct pattern of trigger point distribution that differs significantly from other patient groups and healthy subjects. The trauma might cause scalene muscle injury, resulting in swelling of the area of the anterior and middle scalene muscles. This will show up as swelling in the front of the neck. On lean individuals, you should be able to see the muscles through the skin in the front and sides of the neck.

The best way to tell if your neck is inflamed or swollen is to look at your neck and shoulders in the mirror or take a selfie to see if you can see the outline of the muscles in the neck and the outline of the collarbone.

If these structures are obscured, then perhaps you have inflammation of the area due to the injury of the scalene muscles and other muscles of the neck. For some of you, it might require you to look at old photographs to see if you had the swelling prior to the accident.

In an auto accident injury like this, it is normal for scar tissue to form in the scalene muscles (6), which could result in less-flexible, toughened, stiff muscle tissue surrounding the bundle of nerves and the artery that comes out between these muscles. One study showed a significantly increased amount of muscle scarring in the scalene muscles in those with thoracic outlet syndrome compared to those without (6).

Why do auto accidents cause chronic musculoskeletal pain and chronic thoracic outlet syndrome in so many people? You have a similar impact force with tackles in contact sports like football, which should cause the same strain on the neck, upper back, and shoulder as an auto accident. The athletes seem to recover from 20 to 50 hits every week, while you might have one hit and you are in chronic pain for the rest of your life.

The reason they can handle these hits is because they are trained athletes, who train their upper body for these impacts. They have a greater amount of spring strength, improved resting tone, and spring stiffness to protect them from these hits.

They prepare for the hits in their spring strength training.

Think about it—how many of you include shoulder shrugs to develop the trapezius and levator scapula to reduce the risk of the shoulder impacting or compressing the blood vessels and nerves in the thoracic tunnel?

I will teach you this training routine in Chapter 14, “Spring Training.”

If you were injured in a sports injury or auto accident and need treatment contact our office at 773 735 5200 for an appointment.

References

  • Mandel S. Neurologic syndromes from repetitive trauma at work. Postgrad. Med. 1987;82:87–92.
    http://www.ncbi.nlm.nih.gov/pubmed/3671210
  • Evans RW. Some observations on whiplash injuries. Neurol Clin. 1992 Nov;10(4):975-97.
    http://www.ncbi.nlm.nih.gov/pubmed/1435666
  • Razi DM, Wassel HD. Traffic accident induced thoracic outlet syndrome: decompression without rib resection, correction of associated recurrent thoracic aneurysm. Int Surg. 1993 Jan-Mar;78(1):25-7.
    http://www.ncbi.nlm.nih.gov/pubmed/8473078
  • Brantigan CO, Roos DB. Diagnosing thoracic outlet syndrome. Hand Clin. 2004 Feb;20(1):27-36.
    http://www.ncbi.nlm.nih.gov/pubmed/15005381
  • Brantigan CO, Roos DB. Diagnosing thoracic outlet syndrome. Hand Clin. 2004 Feb;20(1):27-36.
    http://www.ncbi.nlm.nih.gov/pubmed/15005381
  • Sanders R.J., Jackson C.G.R., Banchero N. Scalene muscle abnormalities in traumatic thoracic outlet syndrome. Am. J. Surg. 1990;159:231–236. doi: 10.1016/S0002-9610(05)80269-7.
    http://www.ncbi.nlm.nih.gov/pubmed/2301718/

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