Neck Pain

Question 1

When a patient presents with neck pain, what area should you check?

Answer 1

-one region above and below the area of complaint

Question 2

Pain is a warning sign of what?

Answer 2

tissue injury

-muscle, tendon, ligament, joint capsule, cartilage, etc.

Question 3

What is enthesopathy?

Answer 3

• weakness of the attachment point of a tendon or a ligament to bone
• can be palpated as soft and sharply tender spots at enthesis

Question 4

How long does is take an enthesopathy to heal?

Answer 4

• 8wks

- persistent pain beyond 8wks may be from weakness due to incomplete healing

Question 5

What are the symptoms of enthesopathy?

Answer 5

• chronic pain w/ flares

- pain worse in the morning and w/ activity

Question 6

What is the classic example of an enthesopathy?

Answer 6

-plantar fasciitis

Question 7

True or False: an enthesopathy creates reflexive tension within the muscle that has weak attachments

Answer 7

True

Question 8

What are characteristics of how regional instability causes pain?

Answer 8

• muscles tense due to ligament laxity in an effort to stabilize the joint
• chronic muscle tension and overuse injury may lead to further tears (from the increased tension)

Question 9

What are the characteristics of a somatic dysfunction?

Answer 9

• causes facilitated regions
• -local spasm and hypersensitivity
• -resolves with OMT

Question 10

What ligament would you be palpating superficially at the spinous process, and at the superior and inferior edges of the spinous process?

Answer 10

supraspinous ligament

Question 11

What ligament would you be palpating deeply in between the spinous processes and at the deep portion of the superior edge?

Answer 11

interspinous ligament

Question 12

What types of activities commonly injure the supraspinous and interspinous ligaments?

Answer 12

• slouching
• lifting
• motor vehicle accidents

–straight anterior/posterior mvmts

Question 13

In what types of circumstances would a somatic dysfunction be the primary diagnosis?

Answer 13

• when the somatic dysfunction is unusual
• when the location of the symptom and significant TART findings align
• when the pressure at the SD reproduces symptoms

Question 14

What are examples of some biomechanical causes of neck pain?

Answer 14

-injury or insufficient healing of tendon, muscle, enthesis, capsule, or fascia

Question 15

What are some examples of neurological causes of neck pain?

Answer 15

• nerve impingement or entrapment
• nerve damage
• referred pain
• disease (e.g. MS)

Question 16

What are some respiratory or circulatory causes of neck pain?

Answer 16

• cervical congestion from tight musculature

- superior vena cava syndrome

Question 17

What are some metabolic or energetic causes of neck pain?

Answer 17

• upper respiratory infection
• inflammation reactions
• ankylosing spondylitis
• RA

Question 18

What are some behavioral causes of neck pain?

Answer 18

• posture
• studying
• vision

Question 19

What are some biomechanical ways to approach treatment of neck pain?

Answer 19

• reduce tension
• improve symmetry
• reduce impingement
• reduce strength imbalances

Question 20

What are some neurological ways to approach treatment of neck pain?

Answer 20

• -reduce impingement
• -muscle relaxers
• -antidepressants
• -anti-seizure medications

Question 21

What are some respiratory or circulatory ways to approach treatment of neck pain?

Answer 21

• use lymphatics to reduce tissue congestion

- improve blood flow to improve nutrient delivery

Question 22

What are some metabolic or energetic ways to approach treatment of neck pain?

Answer 22

• reduce inflammation

- -NSAID or steriods

Question 23

What are some behavioral ways to approach treatment of neck pain?

Answer 23

• change study position or improve posture
• take activity breaks
• computer glasses to protect vision
• strengthening and stretching