Document Detail

From railway spine to whiplash--the recycling of nervous irritation.
MedLine Citation:
PMID:  14586283     Owner:  NLM     Status:  MEDLINE    
The search for a specific structural basis for chronic whiplash and other chronic pain and fatigue syndromes has been in progress for decades, and yet currently there remains no "structural" solution to these enigmata. In light of the failure of research to identify the chronic "damage" or pathology as lying in a muscular, bony, or "connective tissue" sites for many chronic pain syndromes like whiplash, fibromyalgia, et cetera, more recent attention has been paid to nervous system structures. Nerve irritation has been implicated as the basis for the pain and other symptoms that are common to many chronic disability syndromes. We postulate here, however, that the concept of nervous irritation has been prostituted for centuries whenever more concrete structural explanations for chronic pain and other controversial illness have been untenable. We suggest that, after each cycle of nervous irritation as a disease, and subsequent dismissal of the notion, the doctrine of irritation as a disease was too good to go away. First, with the hypersthenic and asthenic diseases of the nineteenth century, then railway spine, whiplash, thoracic outlet syndrome, and now brachial plexus irritation, we detect the same pattern: patients with symptoms, but no objective evidence of nerve disease. Nervous irritation has repeatedly served this purpose for the last 200 years. It is our intent that bringing an understanding of this trend will encourage current clinicians and researchers to appreciate the need to abandon this form of speculation without historical insight when dealing with today's controversial syndromes.
Robert Ferrari; Edward Shorter
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Medical science monitor : international medical journal of experimental and clinical research     Volume:  9     ISSN:  1234-1010     ISO Abbreviation:  Med. Sci. Monit.     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-10-30     Completed Date:  2004-02-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9609063     Medline TA:  Med Sci Monit     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  HY27-37     Citation Subset:  IM    
History of Medicine Department, University of Toronto, Toronto, Ontario, Canada.
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MeSH Terms
Chronic Disease*
Neck Pain / etiology
Nervous System / pathology*
Pain / etiology*
Psychophysiologic Disorders
Spine / pathology
Whiplash Injuries*
Comment In:
Med Sci Monit. 2003 Dec;9(12):LE27   [PMID:  14712839 ]

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