Q) Can a whiplash injury cause spondylitis? I was in a crash over a year ago and I am still in incredible pain, with numbness and tingling in right hand.
I never had pain before the accident, and my research points to spondylitis. My doctors are baffled, so I'm trying to diagnose myself. They're giving me a TENS machine.
Lesley, via email (Summer 2015)
A) Let's clear up a bit of unhelpful terminology here. Spondylitis is a bit of a useless term, in my opinion. It refers to inflammation of the joints of the neck and it's used as a diagnosis for a lot of neck problems. But it's a bit of a catch-all phrase that doesn't properly describe what's happening to you – pain in your neck with radiation to the right arm and hand.
What you have by the sounds of things is whiplash (an injury caused by forced forward and backward movement of the head) causing neck pain, probably from the muscles and ligaments that support the spine and, by the sounds of it, some irritation, pressure or injury to the nerves that pass out from the neck. Pain that radiates from the neck to the hand, particularly associated with numbness and tingling, is pretty much the hallmark of injury to the nerves as they leave the spine.
If you've had symptoms for a year and no clear cause has been identified, you need further investigation – an MRI scan firstly and then nerve conduction studies (also called EMG – electromyelography) if the MRI doesn't fully explain what's happening.
That said, a TENS machine is a reasonable suggestion for your pain. It's safe and effective, and can be started while you're waiting for investigations. But the full range of treatment options can only be known when you have a proper diagnosis. If your doctor is baffled, then they need to refer you to someone who can give you a proper diagnosis, explanation and management plan.
This answer was provided by Dr Tom Margham for the Summer 2015 edition of our magazine, Arthritis Today, and was correct at the time of publication.
Send your questions for Dr Tom Margham to firstname.lastname@example.org
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