Neck pain Flashcards
The main cause of neck pain is a disorder of the _______, which usually manifests as neck pain but can refer pain to the head, shoulders and chest
cervical spine
Usual source of cervical spinal pain
the facet (apophyseal) joints
According to an Australian study, about ______of people wake with some degree of neck pain and _____ experience neck pain or stiffness for all of the day
18%
4%
The commonest cause of neck pain is __________ of the facet joints without a history of injury
idiopathic dysfunction
In a UK study radiological cervical disc
degeneration was present in _____ of males
and ___ of females between 55 and 64 years
40%
28%
Strains, sprains and fractures of the facet joints, especially after a_______injury, are difficult to detect and are often overlooked as a cause of persistent neck pain.
‘whiplash’
In cervical spondylosis, osteophytic projections may produce nerve root and spinal cord compression resulting in _______ and _______
respectively
radiculopathy and myelopathy
Cervical disorders are aggravated by _____
vibration
Most episodes of neck pain, including acute
torticollis, are ______
transient, lasting from about 2 to 10 days.
The optimal treatment for dysfunctional joints
(without organic disease or radiculopathy) is _______
active and passive mobilisation, especially as exercises
The so-called myofascial syndrome
is mainly a manifestation of dysfunction of the
______
facet joint
Metastasis to the spine occurs in ______of
patients with systemic cancer, making it the second most common neurological complication of cancer
5–10%
Acute neck pain (ANP) is most commonly _______ or _______
idiopathic or due to a whiplash accident
Evidence of benefit in ANP
• Staying active: resuming normal activities
• Exercises
• Combined cervical passive mobilisation/
exercises
• Pulsed electromagnetic therapy (up to
12 weeks)
Cervical spondylosis following disc degeneration and apophyseal joint degeneration is far more common
than lumbar spondylosis and mainly involves the ______ and_______
C5–6 and C6–7 segments
Character of pain of Cervical spondylosis
- Worse in morning on arising and lifting head
- Improves with gentle activity and warmth (e.g. warm showers)
- Deteriorates with heavy activity
Cx of Cervical spondylosis
- Radiculopathy (unilateral or bilateral)
- Myelopathy—pressure on spinal cord
- Spinal canal stenosis
________ means a lateral deformity of the neck. This is usually a transient self-limiting acutely painful disorder with associated muscle spasm of variable intensity
Torticollis (acute wry neck)
Character of pain of Torticollis (acute wry neck)
- Patient usually awakes with the problem
* Pain usually confined to neck but may radiat
Character of deformity of Torticollis
Deformity of lateral flexion and slight flexion/
rotation
Deformity usually away from the painful side
T or F
Only segment C2 and C7 can cause
torticollis
F
Any segment between C2 and C7 can cause
torticollis
Most like cause of Torticolis
The exact cause of this condition is uncertain,
but both an acute disc lesion and apophyseal joint lesion are implicated, with the latter the more likely cause
This amazingly effective therapy relies on the basic physiological principle that the contracting and stretching of muscles leads to automatic relaxation of agonist and antagonist muscles
Muscle energy therapy
Pain pattern of whiplash injury
The problem can vary from mild
temporary disability to a severe and protracted course
Whiplash usually occurs as a consequence of hyperextension of the neck followed by recoil
hyperflexion, typically following a__________between motor vehicles
rear-end collision
_______ is a working rule for the cervical spine
One disc—one nerve root’
