Neck pain Flashcards
Acute vs chronic neck pain
3 months
List 10 ddx for neck pain
Whiplash Fractures Torticollis Spinal tumor Spinal infection Aneurysm OA DDD Angina/MI Tendonitis RA Reiter's syndrome PMR
Risk factors
Old Female Not employed full time Due to trauma Associated with impaired movements Numbness or tingling Headaches
Red flags
Kernigs sign Headache (aneurysm) lack of rottion No physical aggracating factors B symptoms Infectious symtoms Hx of malignancy
Physical exam to do for neck pain
Kernigs
Spurlings
General palpation, ROM
How to determine if an x-ray is good
You need to see all C1-C7 and T1
If not repeat with swimmers view or get Ct C-Spine
Canadian C spine rules exclusion criteria
Unstable patient Known vertebral disease or surgery GSC<15 Age <16 Pregnancy
What are the canadian C spine rules
Image if: >65 Dangerous mechanism Paresthesias More than a simple rear end collision Not sitting in the ER Not ambulatory at any time Delayed onset of the pain Not able to rotate neck 45 degrees bilaterally
What is the nexus criteria and when do you use it
<16 years old
If any of: Neuro deficit Midline tenderness Intoxication GCS<15 Distracting injuries
What is the one treatment for neck pain with evidence
Pulsed electromagnetic therapy
List five unstable neck fractures
Jeffersons (C1 compression)
Hangmans (C2 bilateral pars)
Bilateral cervical facet dislocations
Clay-shovelers (spinous process of C6 or C7)
Odontoid fracture
Atlanto-Occipital dislocation
Flexion teardrop (anterior inferior vertebral body)
When and how to test for cervical radiculopathy
Spurlings physical exam
EMG and C-spine X-ray imaging
If: Trauma Symptoms >6 weeks with conservative management Malignancy Myelopathy Abscess risk factors
One major safety concern with neck pain
ROM for driving
