Common Cervical Conditions Flashcards
- 47 y.ol male construction worker
- PMH 2 knee surgeries and shoulder surgery
- History of several MVA including 1 roll over accident after drinking
- tingling and numbness in his pinky and ring finger that has worsened since he has been working at the power plant on his latest job assignment
- Cervical Radiculopathy
- Cervical Disc Herniation
- Cervical Disc Bulge
Treatment for Radiculopathy, Herniation, or Bulge
- Traction
- Nerve flossing
- Thoracic Spine Mobs
- Core strengthening
- Neuro based exercises
Diagnose:
- BP = 160/95
- Resting Pulse >100
- Resting Respiration >25
- Fatigue
- Temp >100 F
Not mechanical
Systemic Inflammation or Systemic Disease Process
Diagnose:
- Hand wasting of intrinsics, thenar, or hypothenar eminence
- Unsteady Gait
- Bowel or Bladder disturbances
- Arm Weakness
- Cervical Myelopathy
- Carpal Tunnel
Treatment for Myelopathy or Carpal Tunnel
- Functional training
- Nerve glossing/gliding
- Stretching
Diagnose:
- pain and muscle stiffness following hit in football game
- difficulty turning head and looking down
- HA
Whiplash
Cervical Hyperextension injury
Sprain Strain
Treatment for Whipslash
Neuro based exercises Thoracic Mobility exercises Post concussion management Challenge their balance Work on core work Soft tissue techniques
Diagnose:
- PMH: osteoporosis
- sharp pain
- AROM is extremely guarded and limited
- fell in bathroom last night and hit tub with crown of her head
R/O fracture (jeffersons fracture)
Diagnose:
- job: administrative assistant
- pn is worse at end of week and better after doing yard work over weekend
- walking relieve’s symptoms
- knots in shoulder and back
Fibromyositis
Postural related myalgia syndromes
Cervical Trigger point referred pain
“Tech Neck”
Treatment for Tech Neck
Trigger point treatments (dry needling, ART)
Joint Mobs
Postural education
Thoracic spinal exercises (increase ext and mobility)
Diagnose:
- bilateral/quadrilateral limb paresthesia affected by neck movements
- Hyperreflexia
- Clonus
- +Babinski or Hoffman’s
Cervical Cord Compression
Diagnose:
- 17 YOF
- severe neck pn (12/10)
- cannot move her head in any direction
- denies trauma or fall
- Was fine when she went to bed last night
Cervical Acute Torticollis
Pseudototicollis
Treatment for Torticollis
- MFR for muscle spasms
- Joint mobs if tolerated
- Trigger point treatment
- modalities for pn
- Tractions
Diagnose:
- chronic neck pn
- denies neuro signs
- No weakness
- Mild trigger point tenderness
- palpation does not replicate
- Burning/deep ache that is not pinpointed
- Compression test worsens pn
Facet Syndrome
Annular tear
Internal Disc Derangement
Treatment for Facet Syndrome
- Joint Mobs, HVLA
- Traction
- Core Strengthening
- Neuro based exercises
- Thoracic Mobility exercises
Diagnose:
- mod sized lump under his SCM/jaw line
- Chronic neck/back pn
- Difficulty sleeping at night
- Choking
Refer out for CA testing
non-organic, non-mechanical
Get lymph nodes looked at
Diagnose:
- HA that radiates to back of head
- Symptoms worse over last 2 mo
- pt getting divorced
- 2 children
- Denies arm sx
- vomited 2 days ago
- Better w/ exercise or massage
Upper trap = HA
Stress HA
Fibromyositis
Treatment for stress HA/fibromyositis
- Soft tissue techniques
- Joint mob
- Trigger point therapy
- Postural reeducation
- neuromuscular reed
Diagnose:
- 50 y.o. pt
- constant pn over last 4 mo
- pn is worse at night
- most of eval causes discomfort
- lack consistent capsular patterns
r/o CA
Diagnose:
- 60 YOF
- Mild moderate ache in biceps and neck/upper trap
- Worse at night
- Difficulty sleeping
- Difficulty reaching behind back and across shoulder
- Worse when looking up or reaching overhead
Shoulder OA
Cervicobrachial syndrome
Treatment for OA
treat shoulder
-Isometrics, mobs, scap stabs, RTC reed, inhibit upper traps
Treat C-spine
Treat whole body
Diagnose:
- 48 YOF
- c/o HA
- PMH: MVA 15 years ago
- TMJ
- Spousal abuse
- Distraction causes pn & Compression causes pn
Cericogenic HA
Migraine HA
Muscular referred pn
Contraindications for Manual Therapy
- Joint hypermobility/instability
- Joint inflammation or effusion
- Hard end-feel
- Medically Unstable
- Acute pn that worsens with repeated attempts
- Acute radiculopathy
- bone disease
- detectable fracture
- Spinal arthropathy
- Deteriorating CNS pathology
- Post-joint fusion
- Blood clotting disorder
Precautions to Manual Therapy
- Malignancy
- Total joint replacement
- Bone disease not on radiograph
- Connective Tissue Disorder
- Pregnancy/involving pregnancy
- Recent trauma/cauda equina
- early healing phase
- unable to communicate
- psychogenic pt
- long-term use of corticosteroids
- skin rashes/open wounds
- eleveated pn levels
