& ANSWERS(GRADED A+)
Cervical Strain - ANSWERStems from overuse, whiplash (usually mechanical injury)
Rule out neurological components
The most common cause of acute neck pain is ____. It is usually self-limiting and
resolves with time. Physical therapy can be helpful if symptoms last longer than 2-4
weeks. - ANSWERCervical Strain
A patient presents with neck pain lasting approximately a week. The pain has no
dermatomal radiation. You note taut bands of musculature on palpation. What
condition do these findings suggest? - ANSWERCervical Strain
Types of Neck Pain - ANSWERStrain
Torticollis
Degenerative disc disease
Cervical Disc Disease
Neck pain is chronic if it - ANSWERLasts over 3 months
Identifiable sources of neck pain include: - ANSWERBone, disks, joints, ligaments,
fascia, muscles, and nerve roots.
Axial neck pain - ANSWERNeck pain that remains in the neck region without
radiation into the arms
With axial neck pain - ANSWERMotor strength and reflex examination findings are
normal.
Neck injury history should include - ANSWER-Past medical, social, occupational,
and family history
-Review of systems, including constitutional symptoms, skin changes, visceral pain,
neurologic changes, and bowel or bladder complaints
-History of previous trauma or whiplash should be elicited
-Details surrounding the onset of pain, location and radiation of the pain, quality of
pain over time, and associated symptoms such as headaches or systemic symptoms
-Psychosocial elements including psychological and occupational history should also
be evaluated to look for any confounding variables
Chronic neck pain can also occur after a hyperextension injury (whiplash), usually in
a motor vehicle collision or sometimes during work or sporting events. - ANSWER
In chronic whiplash injury, many structures may be involved, including but not limited
to - ANSWERIntervertebral disks, usually C5-6
Facet joints
Ligaments
, Other cervical soft tissues
Risk factors for neck pain include - ANSWERManual labor occupations
Female gender
Headaches
Smoking
Poor job satisfaction
Poor biomechanics
Cervical spine is made up of - ANSWERseven cervical vertebrae, C2 through C7,
separated by the intervertebral disks, giving this portion of the spine a natural
cervical lordosis.
In the acute phase of neck pain without neurologic symptoms - ANSWERDiagnosis
of cervical sprain and strain is often made without an inciting event, and the precise
diagnosis is not evident.
Cervical radiculopathy - ANSWERTypically the cause of neck pain extending into the
arms.
The pain pattern is usually worse in the arm than in the neck with associated
neurologic symptoms, such as weakness, numbness, and tingling -
ANSWERCervical radiculopathy
One common cause of radicular neck pain is - ANSWERA herniated cervical
intervertebral disk (most commonly at the C6-7 followed by the C5-6 level).
Cervical spondylosis can be due to - ANSWERUncovertebral hypertrophy and is also
a common cause of cervical radiculopathy.
A patient presents complaining of cervical pain and limited cervical ROM. During
physical exam you note weakness of legs, Babinski responses, and loss of vibration
sense in legs. What condition does this suggest? What could cause this condition?
What should you do? - ANSWERCervical cord compression;
Herniated cervical disc, degenerative disc disease with bony spurring, or trauma;
Immediately refer to ortho or neuro
Cervical myelopathy due to spinal cord compression is a possible complication of
cervical spondylosis and can present with - ANSWERNeck pain, radicular extremity
pain, loss of manual dexterity, globally referred symptoms, gait instability, bowel or
bladder dysfunction, and progressive weakness. Such symptoms warrant further
diagnostic evaluation with magnetic resonance imaging (MRI) of the cervical spine if
there is no contraindication.
Radicular neck pain - ANSWER-Usually described as pain greater in the arm than in
the neck but commonly occurring in both.
-Neurologic symptoms, such as pain, weakness, numbness, and tingling, can also
be found in the affected spinal nerve root distribution.