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?
What are some symptoms that can occur with lumbar-sacral spinal dysfunction?
Lower back pain
Posterior leg 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
Constant pain especially severe night pain
Unexplained weight loss
Symptoms in other systems (eg cough, breast mass)
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
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
Radicular pain in arm
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