Neck P! with Mobility Deficit Flashcards
What is the proposed underlying cause of this condition? The Pathoanatomy can be categorized into 2 broad conditions, what are these conditions?
Mobility deficits are caused by impairments to the facet joints and periarticular soft tissue
2 Conditions
- Spondylosis
- Sprain/Strain
With the 2 conditions associated with Mobility deficits, what is the difference between Spondylosis and Spain/Strain?
Spondylosis
- Gradual Progression of age-related joint changes
- Adaptive shortening of the joint connective tissue and periarticular soft tissue
Sprain/Strain
- Acute onset sudden awkward movement causing:
–Muscle strain and/or Ligament sprain
–Primary/secondary disk related injury
–Intra-articular meniscus entrapment
Differential diagnosis for Mobility deficit should include other impairment-based diagnoses. What are those different diagnosis?
- Neck Pain with Movement Coordination impairments
- Neck Pain with Radiating Pain
- Rotator Cuff related shoulder Pain
- Thoracic and/or Rib pain with mobility deficit
What system, structure, pain mechanism (phenotype), and phase of healing are unique to Mobility Deficit patients?
System
- Musculoskeletal
Structure
- Zygopophyseal Joint and Periarticular Soft Tissue
Pain Mechanism (Phenotype)
- Nociceptive
Phase of Healing
- Muscle strain 2-4 weeks, ligament sprain and cartilage injuries 10-12 weeks
With Pts. with Neck P! with Mobility Deficit, what are common subjective reports? What are General Symptoms, Spondylosis Symptoms, and Sprain/Strain Symptoms?
General Symptoms
- Central or Unilateral Symptoms
- Possible (Somatic Referred) UE pain
Spondylosis Symptoms
{Degeneration of tissue, more chronic}
- Gradual onset with Progressive loss of motion
Sprain/Strain
{More Acute, Awkward movement caused immediate P!}
- Immediate onset of pain and loss of motion
- Recent unguarded/awkward movement or position
With Pts. with Neck P! with Mobility Deficits what are Aggravating and Easing Factors?
Aggravating
- Dull ache and stiffness with inactivity
- Symptoms reproduced with certain active movements which may be sharp
Ease
- Staying active
- Progressive cervical spine movement
With this condition, what is common is the 24 hour pain behavior?
Morning
- May have pain and stiffness that is worse upon waking that eases with activity and movement
Noon to Evening
- Symptoms may vary throughout the day depending on the patients activities,
Night
- Symptoms may disrupt sleep with changing positions depending on symptom irritability
With the Movement and Provocation Examination, What will you typically find with AROM with Mobility Deficits?
- Cervical ROM limitations and symptom provocation consistently reproduced at end range
- Symptom provocation with the addition of overpressure and/or combined motions
With the Movement and Provocation Examination, What will you typically find with PIVM with Mobility Deficits?
- Hypomobility of the Cerviothoracic spine with characteristic pattern of restriction
- Hypomobility of the involved segment(s) with local and/or somatic referred symptom reproduction
What is the Diagnostic Test-Item Cluster for pts. with Mobility Deficits?
- Younger individual (age < 50 years)
- Acute Neck Pain (duration < 12 weeks)
- Symptoms isolated to the neck
- Restricted cervical ROM
What is the Clinical Course and Prognosis for this condition?
- Acute Idiopathic neck pain has variable recovery with slowing of progress noted at 6-12 weeks from onset
- Chronic non-specific, atraumatic neck pain may be stable or fluctuating with periods of improvements and worsening
What are factors that may impact prognosis for this condition?
- Older Age
- Prior history of musculoskeletal disorder
- Prior health
- Regular exercise
- History of previous neck pain
- Sick leave
A patient with this condition, how would they present when they are in the Acute stage?
- Severity and Irritability are often high
- Pain at rest or with initial to mid-range spinal movements: before tissue stretch
- Pain control is often the intervention goal at this stage
A patient with this condition, how would they present when they are in the Subacute stage?
- Severity and Irritability are often moderate
- Pain experiences with mid-range motions that worsens with end-range spinal movements: at tissue resistance
- Movement control is often the intervention goal at this step
A patient with this condition, how would they present when they are in the Chronic stage?
- Severity and Irritability are often low
- Pain that worsens with sustained end-range spinal movements or positions overpressure: Overpressure into tissue resistance
- Functional optimization is often the intervention goal at this stage
