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Flashcards in Back and Neck Pain Deck (14):

Name 2 groups at increased risk of quadriplegia from neck manipulation?

People with RA
People with Down Syndrome

Due to the instability of the odontoid process


What are some symptoms that can occur with thoracic spinal dysfunction?

Chest pain
Scapular pain
Paravertebral pain
Costochondrol pain


What are some symptoms that can occur with lumbar-sacral spinal dysfunction?

Lower back pain
Buttock pain
Posterior leg pain
Pelvic pain
Groin pain


What is the commonest cause of low back pain?

Vertebral dysfunction or mechanical pain


What are the potentially serious causes of back pain?

Epidural or subdural abscess


What is the typical pain that presents in spondyloarthropathies?

Inflammatory pain- pain at rest, relieved by exercise


What are the red flags for back pain?

Age > 50
Temp >37.7
Constant pain especially severe night pain
Unexplained weight loss
Symptoms in other systems (eg cough, breast mass)
Significant trauma
Features of spondyloarthropathies


What are the yellow flags in people with acute back pain?

** Psychosocial or occupational factors that may increase risk of chronicity) in people presenting with acute back pain

- Abnormal illness behaviour
- Compensation issues
- Unsatisfactory restoration of activities
- Failure to return to work
- Unsatisfactory response to treatment
- Treatment refused
- Atypical physical signs


What are some symptoms of cervical spinal cord dysfunction?

Pain in neck, ear, face, arm, shoulder, upper anterior or posterior chest
Visual dysfunction


What is the commonest cause of neck pain?

Idiopathic dysfunction of the facet joints without a history of injury


What are the red flags for neck pain?

History of major trauma
Age > 50 yo
Constant pain (day + night)
Fever > 38*
Anterior neck (throat) pain
History of cancer
Unexplained weight loss
Neurological deficit
Radicular pain in arm
Rheumatoid arthritis
Down syndrome


What is whiplash? How does it occur?

Acceleration Hyperextension injury

- Occurs as a consequence of hyperextension of the neck followed by recoil hyperflexion, typically following a rear-end collision of motor vehicles (in a head-on MVC the movements are reversed)

- Causes injury to soft tissue structures including muscle, nerve roots, the cervical sympathetic chain, ligaments, apophyseal joints and their synovial capsules and intervertebral discs

- Damage to the apophyseal joints appears to be severe, with possible microfractures (not detectable on xray) and long-term dysfunction


What are the symptoms of whiplash?

Pain and stiffness of the neck
Headache is a common and disabling symptom that may persist for many months. It is typically occipital but can be referred to the temporal region and the eyes


How do you treat someone with whiplash?

Empathy, reassurance, education
Encourage normalisaiton of activities ASAP
XRAY required
Simple analgesia
Cervical collar for grades II + III (MAX 2 days)
Refer for physiotherapy
Provide neck exercises