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epidemic proportions. This chapter will consider the cervical spine injuries sustained in motor vehicle collisions.
(2) The main principles applying to medical evidence in cases involving soft tissue injuries to the neck:
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1 Acute Soft Tissue Neck sprain is a very common injury.
2 The majority of "whiplash" injuries are minor and cause no more than short term discomfort.
3 The vast majority of patients sustain no more than minor muscle or ligament damage although injury to the facet joints or rarely to a cervical disc may occur.
4 Neck pain, neck stiffness and headache are the most common short and long term complaints which may not necessarily arise on the day of the accident. Most symptoms arise within 48-72 hours post accident.
5 Other physical symptoms include paraesthesia, interscapular and back pain and much less commonly auditory and vestibular complaints.
6 Immediate treatment should be reassurance, use of ice packs non steroidal anti-inflammatory drugs and early mobilisation. The cervical collar should not be provided.
7 No specific physical therapy can be guaranteed to be successful in any particular patient although the different modalities of treatment do appear to be beneficial at least in the short term in many patients.
8 The medico-legal examination must be impartial without the use of emotive or pejorative terms and discussion of liability should be avoided.