Neck Pain

Question 1

List some disorders that cause neck pain

Answer 1

• Cervical strain
• Internal disc disruption syndrome/discogenic pain
• Cervical facet-mediated pain
• Cervical “whiplash” syndrome
• Myofascial pain

Question 2

List some disorders that cause extremity pain

Answer 2

• Cervical radiculopathy

- Cervical spondylotic myelopathy

Question 3

Describe Grade I neck pain

Answer 3

No signs of major pathology and little interference with daily activities

Question 4

Describe Grade II neck pain

Answer 4

No signs of major pathology but may impact daily activities

Question 5

Describe Grade III neck pain

Answer 5

Neck pain with associated neurological signs or symptoms (radiculopathy)

Question 6

Describe Grade IV neck pain

Answer 6

Neck pain with major pathology (e.g., fracture, myelopathy, neoplasm, spinal infection)

Question 7

Neck pain associated with headache, shoulder or hip girdle pain, or visual symptoms in an older person may suggest what?

Answer 7

rheumatologic disease

Question 8

Neck pain with a history of fever, chills, unexplained weight loss, immunosuppression, cancer, or intravenous drug use should raise suspicion for what?

Answer 8

tumor or infection

Question 9

Neck pain with neurological signs or symptoms (arm clumsiness, gait difficulty, bowel or bladder dysfunction, Babinski’s sign) may suggest what?

Answer 9

cervical myelopathy

Question 10

A shock-like paresthesia occurring with neck flexion (Lhermitte’s phenomenon) suggests compression of the cervical cord by a midline disc herniation or spondylosis but may also be a sign of what?

Answer 10

intramedullary pathology such as a multiple sclerosis plaque

Question 11

Anterior neck pain might be a sign of what?

Answer 11

Some type of nonspinal cause

Question 12

What are the most common etiology for axial neck pain?

Answer 12

Degenerative changes

Question 13

Injury to the cervical paraspinal muscles and ligaments associated with spasm of the cervical and upper back muscles are associated with what?

Answer 13

cervical strain

Question 14

What causes a cervical strain?

Answer 14

poor posture and sleeping habits

Question 15

What are symptoms of a cervical strain?

Answer 15

pain, stiffness and tightness in the upper back and shoulder

Question 16

A cervical strain may last up to _ weeks

Answer 16

6

Question 17

What refers to derangement in the architecture of the disc that results in mechanical neck pain with or without features of inflammation

Answer 17

Cervical discogenic pain

Question 18

When are symptoms associated with cervical discogenic pain exacerbated?

Answer 18

when the neck is held in one position for prolonged periods

Question 19

What is the most common cause of whiplash-related neck pain and headaches?

Answer 19

Cervical facet syndrome

Question 20

When there is a nonspecific manifestation of any pathologic condition that causes pain from the neck to the shoulder what disorder is expected?

Answer 20

cervical myofascial pain

Question 21

What is cervical myofascial pain?

Answer 21

Regional pain with associated trigger points, taut bands, and pressure sensitivity

Question 22

What is diffuse skeletal hyperostosis?

Answer 22

Inappropriate bone deposition in the insertions of the ligaments and tendons which leads to stiffness, loss of mobility, and pain

Question 23

Numbness, weakness and a sensation of swelling in the upper limbs is strongly suggestive of what?

Answer 23

Thoracic outlet syndrome

Question 24

What are 2 special tests that can be performed to diagnose thoracic outlet syndrome?

Answer 24

• Roos sign

- Adson’s test

Question 25

List some examples of non-spinal causes of neck pain

Answer 25

• Malignancy
• Vascular
• Cardiovascular
• Infection
• Visceral
• Referred shoulder pain
• Rheumatologic
• Neurologic

Question 26

The cervical spine can rotate an average of __ degrees.

It can bend an average of __ degrees laterally.

Forward flex to __ degrees.

Extend backward __ degrees.

Answer 26

90

45

60

75

Question 27

What movements are more affected by UCS injury? LCS injury?

Answer 27

rotation

lateral flexion

Question 28

What are 2 provocative maneuvers to help diagnose neck pain?

Answer 28

• UE tension tests

- neck distraction test

Question 29

When is radiography indicated in patients with neck pain?

Answer 29

• Constitutional symptoms, such as fevers, chills, and unexplained weight loss
• Moderate to severe neck pain lasting more than six weeks
• Progressive neurological findings
• Infectious risk
• History of malignancy