cx pain

Question 1

Cx Neck Pain

Answer 1

Pain with a postural or mechanical basis, often called cervical spondylosis.
Most common types of neck pain include muscle pain, muscle spasm, headache, facet joint pain, nerve pain, referred pain and bone pain.

Question 2

Bones

Answer 2

7 bones in Cx: C1- C7
Most common bone pain in Cx is OA- wear in cartilage between joints causing bones to rub, producing pain and stiffness
Bones linked together by facet joints

Question 3

Muscles

Answer 3

• Sternocleidomastoid and trapezius enable gross movements in neck
• Most common pain = neck strain which affects muscles + tendons
• Sprain- affects ligaments
• Sprain and strain both involve overstretching or tearing these structures

Question 4

Nerves

Answer 4

• 8 cranial nerves
• C1-3 help control neck and head (flexion, extension and sideflexion)
• C4- Upward movement of shoulders (elevation)
• C5- Controls deltoids and biceps
• C6- Wrist extensors, some innervation to biceps
• C7- Controls triceps and wrist extensors
• C8- Finger flexion
• Pain caused when a nerve branching away from spinal cord is compressed or irritated, tingling is felt at upper extremities

Question 5

Movements

Answer 5

Flexion
Extension
Side flexion
Rotation

Question 6

Causes of neck pain

Answer 6

• Muscle strains- overuse
• Weakness - Overstimulation of one part, e.g. training upper traps more than lower/mid traps
• Worn joints due to age- OA causes deterioration of cartilage between vertebra, osteophytes form that affect ROM
• Nerve compression - Herniated discs or osteophytes can press on nerves branching out of intervertebral foramen
• Injuries- Motor collusions, sporting injuries can result in WAD (rapid acceleration and deceleration of the neck resulting in straining of soft tissues)
• Diseases- e.g. RA, cancer

Question 7

Red flags

Answer 7

Fractures
Instability of vertebrae
CAD
Myelopathy
Cancer
5Ds and 3Ns
Neuro symptoms, e.g. numbness, tingling, P + N

Question 8

5 Ds

Answer 8

Dysphagia (swallowing difficulties)
Dysarthria (problems with speech)
Drop attacks
Diplopia (problems with vision)
Dizziness

Question 9

3 Ns

Answer 9

Nystagmus (involuntary eye movements)
Nausea
Neurological symptoms

Question 10

Outcome Measures

Answer 10

Neck Disability Index
Patient Specific Functional Scale

Question 11

Risk factors

Answer 11

Female
History of neck pain
High job demands
Smoking
Older age
Depressed mood

Question 12

Neck pain with mobility deficits

Answer 12

Central/unilateral neck pain
Limited in neck motion that consistently reproduces symptoms
Associated (referred) shoulder or upper extremity pain may be present
Limited cervical ROM

Question 13

Cervical radiculopathy

Answer 13

Neck pain with radiating pain in involved extremity
Upper extremity dermatomal parasthesia/numbness and myotomal muscle weakness
Positive Cluster of Wainner special test
Numbness, tingling, P + N