OAT Neck Pain

Question 1

What is pain?

Answer 1

warning sign of tissue injury

Question 2

What are sources of acute pain?

Answer 2

muscle
tendon
ligament
joint capsule
cartilage
fascia

Question 3

What does tissue compression cause?

Answer 3

compartment syndromes

nerve issues

Question 4

What is reflex sympathetic dystrophy?

Answer 4

complex regional pain syndrome

in mild forms, differentiated by skin sensitivity & color changes (flushing)

Question 5

What is enthesopathy?

Answer 5

weakness of the attachment point of tendon or ligament to bone

healing is generally complete by end of 8 weeks (later pain is due to incomplete healing)

creates reflexive tension w/ in muscle that has weak attachments

Question 6

What are sxs of enthesopathies?

Answer 6

chronic pain w/ flares, worse in mornings & with activity (think plantar fasciitis)

Question 7

What is regional instability?

Answer 7

due to ligament laxity, usually due to insufficient healing

can lead to chronic muscle tension & overuse injury or further tears from increased tension

Question 8

What is bursitis?

Answer 8

identified by location, fluctuance & tenderness

Question 9

What is somatic dysfunction?

Answer 9

joint, fascia, or muscles that commonly become dysfunctional

joint dysfunction causes “facilitated” regions (local spasm & hypersensitivity)

Question 10

How is somatic dysfunction resolved?

Answer 10

resolves with OMT

Question 11

What sxs are associated with cervical radiculopathy?

Answer 11

reports of scapular area sxs alleviated w/ neck positioning has high likelihood ratio for radiculopathy

Question 12

What are worrisome sxs of cervical myelopathy?

Answer 12

other sx including Hoffman’s
Babinski
Age>45yo
Gait disturbances

Question 13

What are common muscular causes of neck pain?

Answer 13

Scalene m
Longus coli m
Splenius capitis m
Levator scapulae m

Question 14

What are common specific causes of neck pain?

Answer 14

Radiculopathy
Cervical Myelopathy
Upper thoracics
Occipital Neuritis
Carpal Tunnel Syndrome

Question 15

What are common tendinous causes of neck pain?

Answer 15

Scalene m
Longus coli m
Splenius capitis m
Levator scapulae m

Question 16

What are common ligamentous causes of neck pain?

Answer 16

Facet capsule 
Interspinous ligament (of cervical vertebrae)

Question 17

What are common neurologic causes of neck pain?

Answer 17

Scalene m (accounts for 80% of numb/tingling)
Pectoralis minor m
Facet or disc

Question 18

Is the SD the primary DX and causing symptoms?

Answer 18

cause is likely when SD is unusual

cause is likely when location of symptom & significant TART findings align

cause is even more likely when pressure @ SD reproduces quality of pts sxs

Question 19

What are biomechanical causes of neck pain?

Answer 19

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

facial tension imbalance

chronic strains (caused by dz like MS, CP)

leg length

Question 20

What are neurological causes of neck pain?

Answer 20

nerve impingement
nerve entrapment
nerve damage
referred pain
disease

Question 21

What are respiratory/circulatory causes of neck pain?

Answer 21

cervical congestion (from tight muscle)
SVC syndrome

Question 22

What are metabolic-energetic causes of neck pain?

Answer 22

URI or other infection
Inflammation rxns (ankylosing spondylitis, RA)

Question 23

What are behavioral causes of neck pain?

Answer 23

behaviors that lead to tension & strain patterns (posture, studying, vision)

Question 24

What techniques would you use to tx biomechanical causes of neck pain?

Answer 24

reduce tension
improve symmetry
reduce impingement
reduce strength imbalances

Question 25

What techniques would you use to tx neurological causes of neck pain?

Answer 25

reduce impingement

medications (muscle relaxer, anti-depressant, anti-seizure)

Question 26

What techniques would you use to tx resp/circ causes of neck pain?

Answer 26

Lymphatics (reduce tissue congestion)

Improve blood flow (improves nutrient delivery)

Question 27

What techniques would you use to tx metabolic-energetic causes of neck pain?

Answer 27

reduce inflammation (NSAIDs, steroids)

Question 28

What techniques would you use to tx behavioral causes of neck pain?

Answer 28

change studying position
improve posture
activity breaks
vision
strengthening, stretches