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The Cervical Spine
Terms in this set (19)
Name some of the causes of neck pain.
•osteo& rheumatoid arthritis
•myofascial pain syndrome
What will RA due to the atlantoaxial joint?
RA will erode joint and cause it to become unstable.
In regards to neck pain and its causes what are the take home point we should understand?
The exact tissue that is causing a patient's neck pain is most often unknown.
What do you do when you do not know the cause of neck pain?
Start with your assessment
Where do you begin in your assessment with a patient with neck pain due to unknown causes?
Start at the beginning. Clinicians should assess for impaired function of muscle, connective, and nerve tissues associated with the identified pathological tissues when a patient presents with neck pain. Check your PROM, AAROM, AROM, Dermatomes, Myatomes.
What risk factors predispose a person to the development of chronic neck pain?
*Age >40 years
*Coexistence of LBP
*Poor general health
*Bicycling as a regular activity (think head posture/position)
What is one of the best outcome measures we have for neck pain?
Neck Disabilities Index
0-4 points no disability
When classifing a Cervicogenic Headache & Neck Pain With Headaches, which signs and symptoms might the patient present with?
-UNI or BIL HA: mild/moderate/severe
-Pain in neck/suboccipital area, face
-HA intensity precipitated by poor posture, emotional stress
-Related to trauma, DJD, sedentary lifestyle
-Red flags:first or worst HA ever, change in personality or behavior
What is a common strain to the cervical spine?
Whiplash: Extension injury (
probably one of the most common
What is entailed in a whiplash extension injury?
-anterior structures injured
-compression along the posterior elements
-foramen closed down
-TMJ stressed (because it wants to open as you go into extension)
What is another common strain to the cervical spine other than whiplash extension?
Whiplash: Flexion injury
What does a whiplash flexion injury entail?
-anterior compression of v-bodies
-posterior structures elongated
-sub occipital muscles are in pain, elongated
-Disc damage to the jaw due to mouth wanting to close as going into flexion
How will the patient present with a recent whiplash injury present in the clinic?
•pain during contraction orelongation of injured muscle
•localized swelling, warmth
•tenderness to palpation
•protective muscle guarding
•decreased AROM in c-spine and UEs
What specific impairments in function might the patient report in the acute stage of a whiplash injury?
Rolling over, turning, sitting, checking review mirror
What specific impairments in function might the patient report in the subacute and chronic stage of a whiplash injury?
•muscle strength and endurance: push/pull, lift, carry, prolonged postures
•muscle length: limited ROM
Which interventions will best address the impairments associated with neck pain and headaches? (answer came from EBP)
Recommendation based on 185 peer reviewed articles: "Clinicians should consider the use of coordination, strengthening, and endurance exercises to reduce neck pain and headache."
What are the acute stage interventions for Whiplash-Associated-Disorder?
•AROM in pain free range (make sure synovial fluid is moving through the joints, blood flow)
•kinesthetic awareness (need to do proprioceptive training with them. This type of training is not just done for LE, but in many different scenarios. Every where tends to have proprioceptive input.)
•support in neutral during sleep
•educate on early return to normal, non-provocative activities
•assure patient that full recovery is possible
*Help them to rationalize what they are feeling and what is going on with them.
*Accessing for a vestibular problem/component to their injury
Which impairments are prevalent and need intervention in persons with headache and neck pain?
•posture -entire spine-include sleeping
•neuromotor control: lack kinesthetic awareness
•upper thoracic mobility
•muscle performance and endurance -check shoulder girdle too
•joint impairments in upper c-spine
List some interventions you can perform with a person and neck pain.
•cervical & thoracic manipulation/mobilization (more effective with exercise) (helpful in returning mobility and ROM. If paired with exercised it has proven to be more beneficial)
•flexibility exercises: anterior/medial/posterior scalenes, upper trapezius, levator scapulae, pectoralis minor, and pectoralis major
•coordination, strengthening, and endurance
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