OAT Neck Pain Flashcards
Steps of thinking through an osteopathic structural exam
general palpation/ROM, palpation of entire structure, check for SD, check region above and below area of complaint, think about referred pain
Sources of acute pain
muscle, tendon, ligament, joint capsule, cartilage, fascia
Enthesopathies
weakness of attachment point of tendon or ligament to bone
Sxs of enthesopathies
chronic pain with flares, worse in morning and with activity
Regional instability occurs due to…
ligament laxity, often from insufficient healing
Why does instability cause muscle tension?
surrounding muscles are attempting to stabilize the joint
Bursitis
often identified by location, fluctuance and tenderness, near enthesis
Upper anterior neck muscles
mylohyoid, digastric, sternohyoid
Lower anterior neck anatomy
SCM, sternohyoid, longus coli, sternothyroid, thyroid gland
Upper posterior neck anatomy
occipital n. and triangle
Deep posterior neck muscles
splenius capitis, semispinalis capitis, cervical rotatores
Supraspinous ligament
superficial, palpated at spinous process and superior/inferior edge
Interspinous ligament
palpated at interspinous and deep portion of superior edge
Typical mechanisms of supraspinous and interspinous ligaments
slouching, lifting, MVA
Radiculopathy LR with spurling’s
1.9 to 18.6
Radiculopathy LR with upper limb tension, limited rotation, cervical distraction
30.3
Cervical myelopathy sxs
hoffman’s, babinski, age>45, gait disturbances
Common ligamentous causes of neck pain
facet capsule, interspinous ligament issues
SD is the primary diagnosis in neck pain is indicated when….
when SD is unusual, location of sx and significant TART, pressure at SD reproduces quality of sxs
Tx of biomechanical model
in cervical issues
reduce tension, improve symmetry, reduce impingement, reduce strength imbalances
Tx of neurological model in cervical issues
reduce impingement, muscle relaxer, antidepressant, antiseizure
Tx of resp-circulatory model in cervical issues
reduce tissue congestion, improve blood flow and nutrient delivery
Tx of metabolic model in cervical issues
reduce inflammation with NSAID and steroids
Tx of behavioral model in cervical issues
change studying position, improve posture, activity breaks, strengthening, and stretches
