I am having surgery to take pressure off of the spinal cord in my neck. My doctor says the results of my MRI can be used to predict how I will do after surgery. Is this really possible?

As you may know, MRI stands for magnetic resonance imaging, a test that allows doctors to see pictures of tissues in the body. Certain patterns seen on MRI are thought to give an indication of how well a person will do after surgery to take pressure off the spinal cord. When the pattern shows lots of tissue damage in the spinal cord, the results of surgery may not be as good.

Though some patterns have been linked to surgery results, MRI is not a foolproof tool when it comes to predicting how all patients will do. In fact, a test like this is only one piece of the puzzle. Other factors, such as patients’ age and how long they’ve had symptoms, come into play. Younger patients who haven’t had symptoms as long seem to fare better than older patients who’ve had problems for longer. You may want to talk with your doctor to find out how your MRI fits with other information and test results.

I was in a minor rear-end collision a month ago and have been having headaches ever since. Could the headaches be related to my accident?

It’s certainly possible. Whiplash usually restricts neck movement, which can lead to neck pain. Headaches are also commonly reported after a whiplash injury. The good news is that neck movement often improves within three months of minor collisions. And as neck movement improves, headaches usually go away. In the meantime, you may want to talk to your doctor about how to manage your headaches and any other symptoms you may have.

I have whiplash from a minor rear-end car collision. How long will the symptoms last?

A recent study showed that neck stiffness–the main symptom of whiplash injury–goes away within a few months. Three months after a collision, people with minor whiplash had the same amount of neck movement as people who didn’t have whiplash to begin with. Other symptoms such as neck pain and headaches went away as neck movement returned.

However, these results were based on “minor” collisions. Your symptoms may be different, depending on your accident. A physical therapist may be able to suggest helpful strategies to speed your recovery.

Does the speed of your car at the time of an accident make a difference in how bad your whiplash will be?

A recent study tried to answer this very question. Researchers thought that people in faster moving cars would have more severe whiplash. In fact, whiplash–as measured by the amount of neck movement after injury–didn’t change with the speed of the collision. (The speeds of the colliding cars were only about 40 kilometers per hour apart, and the accidents were described as “minor.”) 

Age and body mass played a bigger part in whiplash. The older and larger the person in the car, the more likely he or she was to have less neck movement after the accident.

I had a neck injury playing football, and I’m trying to decide whether to go back and finish the season. I asked two different doctors what I should do, and they told me different things. Why is that? Who should I trust?

Unfortunately, medicine isn’t as cut-and-dried as we would like. Doctors, like people, have different opinions, especially when it comes to guiding athletes who’ve had a neck injury. One doctor’s opinion on these matters may even change over the course of his or her career.

Research has shown that doctors’ opinions have a lot to do with how long they’ve been in practice and their area of specialty. Of course, this doesn’t make it any easier for you to sort through conflicting opinions. It’s hard to weigh the risks and benefits of returning to your sport after a neck injury, especially when some of the risks are unknown. In most cases, returning to the playing field is a personal decision based on the best available advice and with a clear understanding of the potential risks.

My 12-year-old daughter injured her neck in gymnastics, and there’s a big competition coming up. Our doctor says it’s okay for her to participate, but I’m worried. Should I let her compete?

Your doctor’s advice was probably based on the details of your daughter’s injury, along with his or her experience with similar injuries. But if you have doubts, get a second opinion. Be prepared for the fact that the second opinion may be different from the first. Predicting the risk of a future neck injury is not an exact science. Studies have shown that doctors’ advice on these matters depends on their length of time in medical practice and their area of specialty. Along with the advice from your doctor, weigh the risks and benefits before deciding to have your daughter return to sports. 

I had a serious neck injury skiing last winter. I quit the ski team, but is it okay to do other sports?

It depends on which sports you have in mind. Medical research has separated sports into categories based on their level of risk. Collision and contact sports such as football and basketball are generally felt to be riskier than noncontact, high-speed sports such as skiing and gymnastics. Noncontact sports such as running and golf are the least risky. Your doctor can advise you about which sports are safe for you based on your particular injury.

My arm hurts, but my doctor says the problem is in my neck. How can that be?

This type of pain is called referred pain. When the source of your pain is deep in your body, the nervous system has a hard time pinpointing the exact spot that hurts. The pain is often felt farther away from the source. The worse the original pain, the further away it can be felt. Referred pain is usually deep, burning, or aching.

There are many types of referred pain. Pain from a heart attack is often referred to the jaw or left arm. Low back problems can cause pain down the legs. Whatever the case, you need to treat the source of the pain to get rid of the problem. You wouldn’t treat a heart attack by taking drugs to make your jaw or arm feel better. You need to treat your neck problem to regain a pain-free arm. 

I have pain in my upper arm. Why does my therapist do ultrasound treatments on my neck?

The pain in your arm may be caused by a problem in your neck. This is called referred pain, and it can happen for many reasons, all over your body. Heart problems can cause symptoms in your left arm or the jaw. A problem in the low back can cause pain in the hip or leg. When the problem is deep in the middle of your body, your nervous system has a harder time figuring out exactly where the pain is located.

The source of the pain needs to be treated rather than the area that where the pain is felt. As the ultrasound works on your neck, you should start to feel the pain in your arm lessen. 

I drive a forklift, and my neck is really getting sore from always turning my neck to see behind me. What can I do to keep my neck pain from getting worse?

Warm up before you start work by doing some gentle neck, back, and shoulder stretches. Sit with good upright posture while you drive. Keep your chest up and shoulders back. Try to avoid straining your neck when you turn to see behind you. As much as possible, turn your shoulders with your head, so that you aren’t just craning your neck. Assess whether rearview mirrors on the forklift could help you see behind you without having to turn your head as often.

Take frequent breaks as you work. Do some gentle stretching or walk around a bit. During your breaks or after work, try using a cold pack on the sore area. This can help control the pain. 

 If your neck pain continues, see a doctor. Your doctor can help control the pain, and he may be able to help you come up with exercises to help strengthen your neck muscles and improve your posture.