Neck Pain Flashcards
List some disorders that cause neck pain
- Cervical strain
- Internal disc disruption syndrome/discogenic pain
- Cervical facet-mediated pain
- Cervical “whiplash” syndrome
- Myofascial pain
List some disorders that cause extremity pain
- Cervical radiculopathy
- Cervical spondylotic myelopathy
Describe Grade I neck pain
No signs of major pathology and little interference with daily activities
Describe Grade II neck pain
No signs of major pathology but may impact daily activities
Describe Grade III neck pain
Neck pain with associated neurological signs or symptoms (radiculopathy)
Describe Grade IV neck pain
Neck pain with major pathology (e.g., fracture, myelopathy, neoplasm, spinal infection)
Neck pain associated with headache, shoulder or hip girdle pain, or visual symptoms in an older person may suggest what?
rheumatologic disease
Neck pain with a history of fever, chills, unexplained weight loss, immunosuppression, cancer, or intravenous drug use should raise suspicion for what?
tumor or infection
Neck pain with neurological signs or symptoms (arm clumsiness, gait difficulty, bowel or bladder dysfunction, Babinski’s sign) may suggest what?
cervical myelopathy
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?
intramedullary pathology such as a multiple sclerosis plaque
Anterior neck pain might be a sign of what?
Some type of nonspinal cause
What are the most common etiology for axial neck pain?
Degenerative changes
Injury to the cervical paraspinal muscles and ligaments associated with spasm of the cervical and upper back muscles are associated with what?
cervical strain
What causes a cervical strain?
poor posture and sleeping habits
What are symptoms of a cervical strain?
pain, stiffness and tightness in the upper back and shoulder
A cervical strain may last up to _ weeks
6
What refers to derangement in the architecture of the disc that results in mechanical neck pain with or without features of inflammation
Cervical discogenic pain
When are symptoms associated with cervical discogenic pain exacerbated?
when the neck is held in one position for prolonged periods
What is the most common cause of whiplash-related neck pain and headaches?
Cervical facet syndrome
When there is a nonspecific manifestation of any pathologic condition that causes pain from the neck to the shoulder what disorder is expected?
cervical myofascial pain
What is cervical myofascial pain?
Regional pain with associated trigger points, taut bands, and pressure sensitivity
What is diffuse skeletal hyperostosis?
Inappropriate bone deposition in the insertions of the ligaments and tendons which leads to stiffness, loss of mobility, and pain
Numbness, weakness and a sensation of swelling in the upper limbs is strongly suggestive of what?
Thoracic outlet syndrome
What are 2 special tests that can be performed to diagnose thoracic outlet syndrome?
- Roos sign
- Adson’s test
List some examples of non-spinal causes of neck pain
- Malignancy
- Vascular
- Cardiovascular
- Infection
- Visceral
- Referred shoulder pain
- Rheumatologic
- Neurologic
The cervical spine can rotate an average of __ degrees.
It can bend an average of __ degrees laterally.
Forward flex to __ degrees.
Extend backward __ degrees.
90
45
60
75
What movements are more affected by UCS injury? LCS injury?
rotation
lateral flexion
What are 2 provocative maneuvers to help diagnose neck pain?
- UE tension tests
- neck distraction test
When is radiography indicated in patients with neck pain?
- 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
