Transcript CAUSES OF NECK PAIN

NECK PAIN
Prepared by :
Nik Nabilah Nek Rakami
Nawwar Afifah Zakaria
Nurul Iman Noor Zaidi
Nor Aznieda Mohd Rosli
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151
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159
Introduction
• Neck pain (or cervicalgia) is a common
problem, with two-thirds of the
population having neck pain at some
point in their lives.
• Neck pain may come from any of the
structures in the neck including: vascular,
nerve, airway, digestive, and musculature
/ skeletal or be referred from other areas
of the body
CAUSES OF NECK PAIN
Nor Aznieda binti Mohd Rosli
159
Major and severe causes of neck pain
include:
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Carotid artery dissection
Referred pain from acute coronary syndrome
Infections: retropharyngeal abscess, epiglottitis, etc.
Spondylosis - degenerative arthritis and osteophytes
Spinal stenosis – a narrowing of the spinal canal
Spinal disc herniation – protruding or bulging discs, or
if severe prolapse.
Carotid artery dissection
We must differentiate between
pseudoangina and true angina.
spondylosis
Cervical stenosis
Disc herniation
The more common and lesser neck pain causes
include:
• Stress – physical and emotional stresses
• Prolonged postures – many people fall asleep on sofas
and chairs and wake with sore necks
• Minor injuries and falls – car accidents, sporting
events and day to day minor injuries
• Referred pain – mostly from upper back problems
• Over-use – muscular strain is one of the most common
causes
• Whiplash
Prolong posture
whiplash
stress
More causes include
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poor sleeping posture,
torticollis,
head injury,
rheumatoid arthritis,
congenital cervical rib,
mononucleosis, rubella,
certain cancers(metastasis)
ankylosing spondylitis,
cervical spine fracture,
FMS
Nik Nabilah Nek Rakami
06-04-141
Laboratory
test
Other test
1
History and
Examination
3
Imaging test
2
4
History and examination
Lab test
The most important
way to diagnose
myofascial pain
Traditionally does
not produce
abnormalities in the
results of the
patient's lab work
Imaging studies
Often reveal
nonspecific change
only and typically
are not helpful in
making the
diagnosis of cervical
myofascial pain
The patient may present with a history of acute trauma associated with
persistent muscular pain manifests insidiously, without a clear antecedent
accident or injury
Cervical spine ROM is often limited and painful
The patient may describe pain radiating into the upper extremities, accompanied by
numbness and tingling and making discrimination from radiculopathy or peripheral
nerve impingement difficult
Patients often present with poor posture. They
exhibit rounded shoulders and protracted scapulae
While the patient may complain of weakness, normal strength in the
upper extremities is noted on physical examination
Sensation typically is normal when tested formally.
No long tract signs are observed on examination
History and
examination
Lab test
Imaging test
Stiffness of joint
especially at the
morning
Rheumatoid factor
(RF)
Diagnostic changes
also occur in the
cervical spine with
C1-2 subluxation
Pain and swollen
joints
(IgM) antibody
directed against the
Fc fragment (IgG)
Persistent cervical
flexion in AS
History
•Intermittent neck and shoulder pain with parasthesia
•Chronic suboccipital headache
Lab test
•Cyanocobalamin levels and a serum rapid plasma reagin
may help distinguish metabolic and infectious causes of
myelopathy from cervical spondylotic myelopathy
Imaging
study
•Cervical spine films can demonstrate disk-space
narrowing, osteophytosis, loss of cervical lordosis,
uncovertebral joint hypertrophy, apophyseal joint
osteoarthritis, and vertebral canal diameter
Other test
•EMG can identify cervical spondylotic myelopathy
Regularly
spiking fevers
Abscess
cultures with
Gram stains
High WBC
Clotting
profile
Lateral neck
radiography
may reveal
soft tissue
swelling in the
prevertebral
region
CT scans
indicate the
location,
boundaries,
and relation of
infection to
surrounding
neurovascular
structures
Imaging studies
Blood
cultures
Lab test
Torticollis and
decreased
range of
motion of the
neck caused by
inflammation
of the
paraspinal
muscles
History & Examination
Asymmetry of
the neck and
associated neck
masses or
lymphadenopathy
History and Examination
• Patient with symptomatic cervical disc injuries commonly present with
segmental neck pain, muscle spasm, loss of ROM, and referred pain in
both radicular and nonradicular distribution
• Nerve root involvement leads to radicular upper extremity pain,
weakness, and sensory changes
Imaging studies
• Radiographs of the cervical spine may show straightening or reversal
of the normal lordotic curve. This finding is thought to represent
spasm, guarding, or splinting of the muscles that stabilize the neck.
• MRI if detailed analysis of spinal structures and in patients with
persistent arm pain, neurologic deficits, or clinical signs of nerve root
compression
TREATMENT OF
NECK PAIN
Nurul Iman Noor Zaidi
06-4-152
Physical
therapy
surgery
exercise
treatment
medication
Alternative
treatment
Physical therapy
• ice or heat
• electrical
stimulation therapy
• Neck traction
• Massage therapy.
Exercise therapy
• strengthening and improving the
muscles, tendons, and ligaments
that support the vertebrae
• Physical therapists can instruct you
on proper posture, lifting, and
walking techniques
Alternative Therapy
• chiropractic
manipulation
• acupuncture
• Herbal Remedies
Capsaicin Cream
Devil's Claw
White Willow
Bark
• Yoga
Medication
1.
nonsteroidal anti-inflammatory drugs
-ibuprofen
-naproxen
to reduce inflammation and relieve pain
severe
• analgesic
-taken with the NSAID or muscle relaxant
2.
Steroids
-reduce the swelling
-reduce inflammation of the nerves
-immediate pain relief within 24-hours.
Surgery
• rarely recommended….unless you have;
• a proven disc
herniation,
• cervical cord
compression,
• problems with
balance and
coordination,
• the pain is severe
• The surgical procedures to treat neck
pain includes :
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Anterior cervical discectomy
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Laminectomy
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Laminoplasty
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Cervical spinal fusion.
-for instability;
-rheumatoid arthritis
-car accident
subluxation
Neck Pain Prevention and
Relief
Nawwar Afifah Binti Zakaria
151
Examine your home for potential hazards
Proper exercise of the shoulders and neck
When performing hazardous tasks, have
someone present to reduce the likelihood
of injury
Know your
limitations
Wear seat
belts
Stay as
active as
possible
Wear neckcollar
Reduce your
stress and
tension
Stop smoking
Eat healthy and get
enough calcium
Check how your
computer is set up at
home or at the office