Neck pain

Question 1

The main cause of neck pain is a disorder of the _______, which usually manifests as neck pain but can refer pain to the head, shoulders and chest

Answer 1

cervical spine

Question 2

Usual source of cervical spinal pain

Answer 2

the facet (apophyseal) joints

Question 3

According to an Australian study, about ______of people wake with some degree of neck pain and _____ experience neck pain or stiffness for all of the day

Answer 3

18%

4%

Question 4

The commonest cause of neck pain is __________ of the facet joints without a history of injury

Answer 4

idiopathic dysfunction

Question 5

In a UK study radiological cervical disc
degeneration was present in _____ of males
and ___ of females between 55 and 64 years

Answer 5

40%

28%

Question 6

Strains, sprains and fractures of the facet joints, especially after a_______injury, are difficult to detect and are often overlooked as a cause of persistent neck pain.

Answer 6

‘whiplash’

Question 7

In cervical spondylosis, osteophytic projections may produce nerve root and spinal cord compression resulting in _______ and _______
respectively

Answer 7

radiculopathy and myelopathy

Question 8

Cervical disorders are aggravated by _____

Answer 8

vibration

Question 9

Most episodes of neck pain, including acute

torticollis, are ______

Answer 9

transient, lasting from about 2 to 10 days.

Question 10

The optimal treatment for dysfunctional joints

(without organic disease or radiculopathy) is _______

Answer 10

active and passive mobilisation, especially as exercises

Question 11

The so-called myofascial syndrome
is mainly a manifestation of dysfunction of the
______

Answer 11

facet joint

Question 12

Metastasis to the spine occurs in ______of

patients with systemic cancer, making it the second most common neurological complication of cancer

Answer 12

5–10%

Question 13

Acute neck pain (ANP) is most commonly _______ or _______

Answer 13

idiopathic or due to a whiplash accident

Question 14

Evidence of benefit in ANP

Answer 14

• Staying active: resuming normal activities
• Exercises
• Combined cervical passive mobilisation/
exercises
• Pulsed electromagnetic therapy (up to
12 weeks)

Question 15

Cervical spondylosis following disc degeneration and apophyseal joint degeneration is far more common
than lumbar spondylosis and mainly involves the ______ and_______

Answer 15

C5–6 and C6–7 segments

Question 16

Character of pain of Cervical spondylosis

Answer 16

• Worse in morning on arising and lifting head
• Improves with gentle activity and warmth (e.g. warm showers)
• Deteriorates with heavy activity

Question 17

Cx of Cervical spondylosis

Answer 17

• Radiculopathy (unilateral or bilateral)
• Myelopathy—pressure on spinal cord
• Spinal canal stenosis

Question 18

________ means a lateral deformity of the neck. This is usually a transient self-limiting acutely painful disorder with associated muscle spasm of variable intensity

Answer 18

Torticollis (acute wry neck)

Question 19

Character of pain of Torticollis (acute wry neck)

Answer 19

• Patient usually awakes with the problem

* Pain usually confined to neck but may radiat

Question 20

Character of deformity of Torticollis

Answer 20

Deformity of lateral flexion and slight flexion/
rotation

Deformity usually away from the painful side

Question 21

T or F
Only segment C2 and C7 can cause
torticollis

Answer 21

F

Any segment between C2 and C7 can cause
torticollis

Question 22

Most like cause of Torticolis

Answer 22

The exact cause of this condition is uncertain,

but both an acute disc lesion and apophyseal joint lesion are implicated, with the latter the more likely cause

Question 23

This amazingly effective therapy relies on the basic physiological principle that the contracting and stretching of muscles leads to automatic relaxation of agonist and antagonist muscles

Answer 23

Muscle energy therapy

Question 24

Pain pattern of whiplash injury

Answer 24

The problem can vary from mild

temporary disability to a severe and protracted course

Question 25

Whiplash usually occurs as a consequence of hyperextension of the neck followed by recoil
hyperflexion, typically following a__________between motor vehicles

Answer 25

rear-end collision

Question 26

_______ is a working rule for the cervical spine

Answer 26

One disc—one nerve root’