Musculoskeletal Pain Emanating from the Head and Neck: Current Concepts in Diagnosis, Management and Cost Containment

• injury mechanisms, threshold for injury, and impact severity
• long-term outcomes of whiplash injury
• psychological aspects of chronic pain and disability
• dizziness, imbalance, and chronic incapacity
• intervertebral joint injuries and cervical synovial joint injuries
• the Neck Disability Index
• manipulation and mobilization therapies
• temporomandibular disorders/temporomandibular pain and dysfunction syndrome (TMPDS)
  
  Musculoskeletal Pain Emanating From the Head and Neck is not simply a collection of studies presenting data and findings--rather, it is a compilation of knowledge that illuminates the challenges of treating whiplash and makes some strong and straightforward recommendations for improvement. The contributors and the editor stress to the reader that in order to provide the best possible care, providers must be alert to the many secondary manifestations of whiplash, test for the perception of dysfunction, and be reassuring whenever possible. They must foster an atmosphere of confidence, encourage very early activation, and help persons maintain the momentum of their lives. Furthermore, Dr. Allen calls for caregivers to stop most (if not all) drug treatments, avoid passive failure-mode treatments, and avoid prolonged medicalization of any form of treatment.
  
  By studying the findings and following the recommendations of the international experts contributing to Musculoskeletal Pain Emanating From the Head and Neck, physicians, chiropractors, and physical therapists will foster self-reliance in their patients and improve diagnosis, treatment, and cost containment of whiplash.
  
  

Interestingly, some people try to use this book to sell themselves to Plaintiff lawyers as hired gun able to deal with defensive 'experts' when they rely on, and vigorously defend Allen's article by using his own book to basically discredit his earlier article. Thanks to Freeman, Croft, Reiser et al's paper later in Spine, some Plaintiff experts have actually been able to reap huge financial rewards, and victimise patients and society at the same time, since they have been hired to serve Plaintiff lawyers and themselves only.

Again, Dr. Murray Allen has a balanced view of whiplash, just as the other international expert, Dr. Ferrari.

I wish that we could find a way to eliminate the 'money-seeking Plaintiff experts' from the academic and medicolegal pool. I get tired of haring the same arguments used for monetary gain and trying to make sure that expert testimony matches what the Plaintiff lawyer wants to hear. Fortunately, the vast majority of care givers do otherwise. I commend Dr. Allen for 'biting his tongue' and letting Dr. Croft have a voice where everyone else has stopped listening to the nonsense thereof. Now, if we just could get someone to wake up Lommell...


Murray Allen - reformed 'expert'?   June 20, 2000
Dr. Daniel R. Lommell (Quad Cities, IL)
5 out of 6 found this review helpful

Having treated numerous whiplash victims, and having gone against numerous insurance companies, I am continually amazed at the defense's reliance on Dr. Allen's 'Pertubations' article from Spine. I was rather reluctant to buy his book, but in fairness and balance, I didn't feel my library would be complete without it. I was pleasantly surprised that he includes articles by Radanov, Bogduk and Croft, among others.

Interestingly, I am now able to use this book and the articles in it when I come up against these defensive 'experts' when they rely on, and vigorously defend Allen's article by using his own book to basically discredit his earlier article. Thanks to Freeman, Croft, Reiser et al's paper later in Spine, combined with this book, I have actually been able to embarrass these guys, and protect patients they have been hired to assail.

Again, Dr. Murray Allen has a jaded view of whiplash, just as the other incompatent, Dr. Ferrari. In context, based on the source, one can use this book as a tool.

I wish that we could find a way to eliminate the 'junk science' from the research pool. I get tired of having the same 10-15 articles used against my patients trying to 'prove' they couldn't be hurt. Unfortunately, the vast majority of the evidence shows otherwise. I commend Dr. Allen for 'biting his tongue' and including Dr. Croft after he was discredited by same. Now, if we just could get someone to wake up Ferrari...


Perturbations of the Truth   January 15, 2000
16 out of 18 found this review helpful

Murray Allen brings to the textbook world more nonsense from his experience as pseudo-researcher. Anyone interested in the phenomenon of whiplash injuries should avoid this shallow book.

Allen wrote an article for the journal SPINE (1995) discussing accelerations in low-speed automobile collisions and compared them to everyday benign activities such as skipping rope and plopping into chairs. He postulated that injuries were not possible and that injury cannot exist at low speeds.

Unfortunately for Dr. Allen, that article has been debunked in academic circles in medicine and engineering. The article is an example of what happens when you have medical editors reviewing articles about physics: they haven't got a clue.

Allen failed to understand the physics of whiplash by looking at the short bursts of acceleration caused by plopping into chairs and skipping rope. TWO factors must be present to determine the injury potential in whiplash accidents: acceleration AND delta V. Plopping, etc. have accelerations APPROACHING those of whiplash at low speeds (still not quite as high, Dr. Allen), but THERE IS NO DELTA V. Car crashes happen over several HUNDRED milliseconds, and in spite of Allen's use of language devised to confuse, his rope-skippng and chair-plopping delta V's are on the order of magnitude of only TENS of milliseconds. And that is a critical difference.

Allen also ignored the fact that vehicles weigh 2500 lbs. and more, that today's cars are HEAVIER (not lighter, as he implies) than the vintage World War II cars he talks about (Severy et al. research). Since in PHYSICS, Force equals Mass times Acceleration, or F = ma, Allen ignores the force of a 2500 lb. object hitting you versus a 50-85 lb. child hitting a chair or the ground (in cushioned sneakers no less). In addition, the epidemiological literature on whiplash is massive. Does he really think that whiplash doesn't exist at low speeds? Is the emergency room filled with rope-skippers and chair-ploppers? Are ALL of the people injured in collisions at low speeds faking? Why is it that several outcome studies show long-term disability and chronic pain YEARS AFTER the lawsuits are settled? Epidemiology proves that most injuries occur at speeds of 6-12 mph, whereas vehicle damage thresholds are higher. Doesn't Dr. Allen know anything about the physics of plastic (deformation and damage to vehicles) vs. elastic collisions (low-speed collisions where the damage from the energy of collision is transferred to the vehicle OCCUPANTS)? His "perturbations" study was TOTALLY BOGUS, and certainly naive.

And that means that Allen is one of two things: grossly undereducated in physics, biomechanics and the medicine of whiplash...or, perhaps was romancing the auto insurance industry who would love nothing more than to continue denying claims for real injuries. Take your pick. He is NOT TO BE TRUSTED.

Further, Allen claimed in that article that Severy found no injuries in his crash tests at UCLA in the 1950's. Did he even read Severy? A closer look at Dr. Allen's past writings will reveal that he draws conclusions from his own studies on whiplash he has no business drawing. That an article as weak as "Perturbations" could ever be published is a testament to journal editors' need to SELL journals, and to sell controversy with JUNK SCIENCE. If Allen has ever gone to court as an expert witness and used his article, he should realize that many physicists, hard scientists, medical professionals and whiplash victims are on to him.

I urge all whiplash sufferers to read the scientific literature on low-speed crash testing, especially works by Ono, Kanno, Panjabi, Brault, Siegmund, Croft, Freeman, and the many other real scientists who are telling the truth about whiplash. Injuries start at rear-end collision speeds of 2.5 mph. Surprised? The truth is in the literature.

You will not find the truth in Allen's book. Is he a lacky-boy for the defense attorneys who represent the insurance industry, or the industry itself? Is greed at the heart of such writing? One has to wonder.

I hope Dr. Allen reads this and changes his ways, if he hasn't since that AWFUL 1995 article. Otherwise, he might find himself a patient with injuries sustained in a low-speed rear-end collision with no one to empathize, and unable to sleep at night. In fact, I don't know how he can sleep now.

This book is no help to the millions of innocent victims of car crashes. The ideas in this book about whiplash are truly superficial. This book and the one by Ferrari are misusing the literature to fool people, and to help the auto insurance industry and their representatives. There is no reality here, just another perturbation of the truth.