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MSK 1 - Cervicothoracic > Cervicothoracic Spine II > Flashcards

Cervicothoracic Spine II Flashcards

1
Q

What condition creates “muddying of sensation”

A

Nociplastic pain

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2
Q

What are some neck pain functional questionaires?

A

General - Neck Disability Index (NDI)
Whiplash Associated Disorder (WAD)

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3
Q

What percentage of people will experience neck pain?

A

70%

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4
Q

What percentage of people will experience PERSISTENT neck pain?

A

33-44%

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5
Q

What is the cost of neck pain second to?

A

Worker’s comp costs

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6
Q

Which population experiences neck pain more?

A

Women

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7
Q

Is neck pain more common in older or younger people?

A

Older

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8
Q

What part of the spine has the smallest amount of spine related pathology?

A

Thoracic

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9
Q

What are the strongest risk factor for Neck pain?

A

Female
HX of neck pain

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10
Q

What are some other risk factors for neck pain?

A

Over 40 years of age
Coexisting LBP
Regular cycling
Hand weakness
worrier
poor quality of life
low vitality
high job demands
smoking
low social/work support

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11
Q

What is the etiology of neck pain?

A

Most often unidentified
- typically Mechanical Neck Disorder
- Nerve root compromise

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12
Q

What is the functional range of motion for extension of the neck?

A

50-70 degrees to look up

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13
Q

What is the functional range of motion for rotation of the neck?

A

60-70 degrees for driving
full is 70-90

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14
Q

What are signs and symptoms of neck pain?

A

Varied
patterned
impaired scapular mechanics

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15
Q

What does imaging fail to do?

A

identify symptomatic structures

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16
Q

What are MRIs good at finding?

A

asymptomatic MRI findings in the neck
-50-73% with bulging and herniated discs
-94% annular tears
-13% cord compression

17
Q

What is not good about tests and measures for neck pain?

A

Poor screening tools and lack diagnostic accuracy

18
Q

Why are JMs recommended for neck pain?

A

JM to modulate neck muscle function, increase deep muscle recruitment, reduce superficial muscle recruitment

19
Q

What are JMs more effective than?

A

PCP or non-manual Rxs

20
Q

Why are Cervical Manipulation CPRs helpful for neck pain?

A

predict success

21
Q

Name some CPRs for neck pain?

A

Bilateral involvement
Sedentary work more than 5 hours a day
feeling better with movement
extension does not increase symptoms
OA without radiculopathy

22
Q

What are the MOST RECENT CPR for cervical pain?

A

Symptoms over 38 days
less than 10 degrees difference in rotation
pain with PA springs

23
Q

What are some Thoracic manipulation CPRs?

A

Symptoms over 30 days
No symptoms distal to shoulder
Extension does not increase symptoms
Fear avoidance beliefs questionnaire under 12
Diminished T3-5 kyphosis
Cervical extension less than 30 degrees

24
Q

What kind of neck pain is MET effective on?

A

Acute and persistent neck pain

25
Q

What kind of METs should we prescribe for nociplastic pain?

A

Motor control and strengthening exercises for stabilization
30-60 minute sessions
2-3 x a week
7-12 weeks

26
Q

What should our METs for cervicothoracic spine focus on?

A

Local and global muscle training

27
Q

Is there strong evidence for MET for cervicothoracic spine?

A

Yes

28
Q

What are the parameters for METs for cervicothoracic spine?

A

8-12 visits
2x a week for 6 weeks led to benefits that lessened by 6 months
3x a week over 1 year was till good at 3 years

29
Q

Is stretching beneficial in isolation?

A

NO

Needs to be combined with MET

30
Q

Are modalities recommended for cervicothoracic pain?

A

Current evidence is lacking, not recommended

31
Q

Is pt education/counseling effective for cervicothoracic pain?

A

YES - strong evidence
- early movement without provocation
-reassurance of good prognosis and full recovery

32
Q

What is the prognosis for ACUTE neck pain?

A

mild problems with rapid recovery (~45%)
moderate problems with incomplete recovery (~40%)
severe problems and no recovery (~15%)

33
Q

What are some indications for a worse prognosis of neck pain?

A

Pain over a 6/10
NDI less than 30%
Pain catastrophizing
Post traumatic stress
cold hypersensitivity

34
Q

Why are major limitations of pharmaceuticals important?

A

Lack of replications of findings, creates inconsistent results

35
Q

Are epidural injections effective?

A

Limited evidence of effectiveness

36
Q

Are NSAIDs effective for neck pain?

A

NO - limited evidence of effectiveness

MSK 1 - Cervicothoracic (7 decks)

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