Science topic

Neck Pain - Science topic

Discomfort or more intense forms of pain that are localized to the cervical region. This term generally refers to pain in the posterior or lateral regions of the neck.
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Dolor cervical en APS
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Es dependiente en primer lugar de la etiología del dolor cervical y de la cronicidad del mismo.
Para un dolor cervical agudo, lo más importante es determinar la etiología.
En general, el dolor cervical crónico suele tener un buen tratamiento mediante ejercicio, terapia manual y otros procedimientos propios de la fisioterapia.
En casos de dolor neuropático, o dolor muy agudo, se puede valorar la administración de corticoides u otros fármacos analgésicos, aunque no sería mi campo de mayor conocimiento.
La cirugía en cambio queda reservado a casos muy particulares.
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I have patients with neck pain. I am testing them then giving them a 4-weeks rehab program then testing them. I want to measure the responsiveness of an outcome measure, for example, the range of motion in the cervical spine pre and post-rehabilitation program.
What's the best statistical test to measure the responsiveness (change over time) of my outcome measure?
Regards
Ahmad
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Thnx all
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for example, i was searching for "chronic neck pain and resistance Training" and so many publications appeared for that Topic, but i can't find the exact number of articles, which appeared here. How can I find out, how many articles appeared for my search? (Don't want to Count all of them haha)
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Agree, depends on search engine. Can you tell us more?
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Middle aged man with neck pain (within 24h) due to significant epidural hematoma of the cervical spine. Under thrombolytic therapy. No neurologic deficits.
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conservative treatment
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Cervical spondilysis, neck pain, back pain in rough bikers, long sitting computer professionals get frequent pain and cervical spondilitis. The long neck covering band is uneasy, tough, and uncomfortable and it gives bad look over the collar. We started making a collar band which is narrow soft, good looking and. relieving pain too. We wish to market this cheap product. Do you need this. ?
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I need a postal address to send sample of this no drug balm for your tests
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We have a set of routinely collected data of about 10.000 patients with musculoskeletal pain (neck pain, thoracic pain and low back pain). We have collected the data in a primary care physiotherapy practice based on standardized registration forms. We don’t have found any comparable publication. We are not sure what is the best way to analyse this total dataset or in subgroups. Who has any experience in processing routinely collected data? Who has published a paper as result of analysis of routinely collected data in primary care physiotherapy practice?
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Dear Ina,
Hope you are doing well.
Thanks for your valuable reponse. Our routinely collected data are fully organized according to the steps of clinical reasoning and decision making, Roughly on the same way you teach your students..
An example illustrates the embedding of the clinical reasoning process in patients with Whiplash-Associated Disorder.
A flowchart illustrating the steps of the clinical reasoning process in patients with Whiplash-Associated Disorders (WAD) is as supllementary available in ReserachGate (Supplementary data: Quality indicators for physiotherapy care process of patients with Whiplash-Associated Disorders (WAD). Flowchart of steps of clinical reasoning Related to the article: Has the quality of physiotherapy care in patients with Whiplash-Associated disorders (WAD) improved over time? A retrospective study using routinely collected data and quality indicators. Published in: Patient Preference and Adherence 2018:12;2291-2308).
Supplementary data - Steps of Clinical Reasoning Process and overview of variables of quality indicators for the physiotherapy care process in patients with Whiplash-Associated Disorders (WAD) related to article: Has the quality of physiotherapy care in patients with Whiplash-Associated disorders (WAD) improved over time? A retrospective study using routinely collected data and quality indicators. Published in: Patient Preference and Adherence 2018:12;2291-2308.
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Hi friends
Is there any provocative test to assess the pain in cervical facet joints
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Dear Dr. Kumar
To test for facet joint in the cervical spine we need first to make sure there is no radiating pain or numbness in the upper extremity. The pain should be local. To test for the facet joint you need to put the head in slight extension and lateral bending (diagonal) and use compression to the right and to the left side to elicit pain. Pain is indication of cervical facet joint inflammation
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Congrats on the interesting project, but before migrane- neck pain!
I have not managed to find much about aerobic exercise training in neck pain. Have you found some solid evidence to support aerobic training in neck pain? will be happy to share!
If not- let's do one!
sincerely,
Hilla
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Hi,
Quite a remarkable question. Can aerobic exercises in some moderate dose be harmful?
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Young adults age would be between 19-29 years. 
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Muhammad sir, I have already started the conference paper study taking more sample size. Thank you for the appreciation! 
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hi every one from researchers and practitioners i'm a PHD candidate and i want ask you a question>>  i would like to ask if any one know the prevalence of neck pain among Egyptian people ?
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Dear Saied,
I did a small prevalence study on prevalence of neck pain in South Africa private physiotherapy practices. I cam to realise that there is basically no information available for the whole of Africa. I think, considering the impact of neck pain globally, that it is important that we get this kind of information for Africa
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As a PT, I work with patients with Post-concussion syndrome.  (I have noticed multiple patients with this diagnosis have excessive chest, upper trapezius and accessory muscle use while breathing, which may have to do with the high incidence of neck pain and headaches in this population, but want to see if anyone else has noticed this). I also wonder if this is due to the hits to the head which may interfere with C3,4,5; which may involve inhibiting diaphragm at some time during their injury. I do not believe there is research on this yet.
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I realize this thread is somewhat older, but will offer some input.  There is a potentially far less sexy explanation...anxiety.  The strongest predictor of postconcussion syndrome is preexisting psychiatric symptoms, and anxious breathing presents just as you're describing.  Depending on the population you work with, the removal from work/school/athletics/etc. that accompanies the acute recovery process commonly progresses to anxiety and other symptoms unrelated to any specific underlying pathology.  Even if they did not have a preexisting condition, the anxiety can result from the concussion as a stressful event.  There is strong evidence suggesting that the physiological effects of concussion are strongest acutely, but then give way to psychological and psychosocial influences.  This does not mean the symptoms aren't real, it just means their etiology may not be underlying damage from the brain injury per se.  The Buffalo Treadmill Test from Leddy et al. offers a nice way to try and tease out whether lingering symptoms have a physiological basis or not.  
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Some of the Yoga experts suggest neck rotation in the problem of cervical spondylitis, whereas some suggests not to perform this practice. Can we get the right answer?
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Very good points. This is the way to avoid the upper cross syndrome.
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Does anyone have an idea or that overuse of the neck can cause cerebral infarction resulted from thrombus in the internal carotid artery?
A 61-year-old male was brought to the emergency department with complaints of left side paralysis and speech disturbance. The symptoms supposedly appeared while he was sleeping. Apparently, the patient could not move his left hand and leg. He was alert and his blood pressure was 120/60 mmHg. He has no history of hypertension, diabetes, or hyperlipidemia. He does not consume alcohol or smoke. According to his wife, he complained of right side neck pain in the preceding day after he played Kendo _ Japanese martial art. There were no apparent bruises or wounds in his right neck. 
USG revealed the thrombus at the trunk of right internal carotid artery. CT revealed no bleeding but the high intensity lesion in the right middle cerebral artery, indicating clots in the vessel. MRI showed the high intensity lesion in the right basal ganglia. MRA showed the deficit of the blood flow in the right ICA. Then, he was diagnosed as acute stroke resulting from thrombosis in the ICA. Thinking of the interval of the onset, he was not considered as a candidate of interventional radiology followed by iv t-PA treatment. Then, conservative treatment by edaravone and antithrombin agent were initiated.
In this case, I wonder if there are some relationships between sports and cerebral infarction. I am interested in the involvement of external force or overuse of neck as the cause of his illness.
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Hi Nobuhiro
There is one case report published on this (Suzuki et al, 2012). The patient was a 66-year-old male who presented with left hemiplegia after having recieved a frontal thrust (tsuki) during the practice of Kendo. The authors state that the frontal thrust of Kendo can cause cervical artery dissection and stroke, but that's quite rare.
The reference is the following:
Hope this is helpful to you
All the best
Rodrigo
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There are more studies explaining about chronic pain and inability of patient to repeat the Joint Re position test in both cervical and Lumbar region. I would like to know how can we measure it precisely in clinical set up. Any reliable scale to grade the error?
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Hello, some articles that can help you, kings regards.
1. Arch Phys Med Rehabil. 1994 Aug;75(8):895-9.
Changes in cervicocephalic kinesthesia after a proprioceptive rehabilitation
program in patients with neck pain: a randomized controlled study.
Revel M(1), Minguet M, Gregoy P, Vaillant J, Manuel JL.
Author information:
(1)Laboratoire d'Explorations Fonctionnelles de l'Appareil locomoteur et
d'évaluation du handicap, Hôpital Cochin, Paris, France.
Head repositioning accuracy (HRA) after full range active motion was evaluated in
60 cervicalgic patients. The mean angular error was 7.7 degrees +/- 3.3 (mean +/-
SD) and 82% were outside a threshold value of 4.5 degrees. After randomization 30
patients followed a rehabilitation program based on eye-head coupling (RG) and 30
served as a control group (CG). At 10 week follow-up, a greater gain in HRA was
observed in the RG (2 degrees +/- 2.7, mean +/- SD) than in the CG (0 +/- 2.6,
mean +/- SD) (p = 0.005). Clinical parameters (pain, drug intake, range of
motion, and self assessed functional improvement) were also more improved in the
RG than in the CG. These data emphasize the role of a neck proprioception
alteration in chronic neck pain and suggest that a rehabilitation program based
on eye-head coupling should be included in most medical management of cervicalgic
patients.
PMID: 8053797 [PubMed - indexed for MEDLINE]
2. Arch Phys Med Rehabil. 1991 Apr;72(5):288-91.
Cervicocephalic kinesthetic sensibility in patients with cervical pain.
Revel M(1), Andre-Deshays C, Minguet M.
Author information:
(1)Department de Reeducation, Clinique de Rhumatologie, Hopital COCHIN, Paris,
France.
Head orientation in space makes use of multiple sensory afferents, among which
the cervical proprioceptive cues could play a predominant role. To quantify the
alteration of neck proprioception in patients with cervical pathology, we
proposed a test for the clinical evaluation of the ability to relocate the head
on the trunk after an active head movement, for 30 healthy subjects and 30
patients with cervical pain. The data demonstrated that this ability was
significantly poorer in the patient group, indicating an alteration in neck
proprioception. This test permits a discriminant classification of healthy and
sick subjects, justifies proprioceptive rehabilitation programs, and allows a
quantitative evaluation of their results.
3. Physiother Theory Pract. 2008 Sep-Oct;24(5):380-91. doi:
10.1080/09593980701884824.
Test-retest reliability of cervicocephalic relocation test to neutral head
position.
Pinsault N(1), Fleury A, Virone G, Bouvier B, Vaillant J, Vuillerme N.
Author information:
(1)Laboratoire TIMC-IMAG, UMR UJF CNRS 5525, Grenoble, France.
Considering the important role of the cervical joint position sense on control of
human posture and locomotion, accurate and reliable evaluation of neck
proprioceptive abilities appears of great importance. Although the
cervicocephalic relocation test (CRT) to the neutral head position (NHP) usually
is used for both research and clinical purposes, its test-retest reliability has
not been clearly established yet. The purpose of the present experiment was to 1)
evaluate the test-retest reliability of the CRT to NHP and 2) to determine the
number of trial recordings required to ensure reliable measurements. To this aim,
40 young healthy adults performed the CRT to NHP on two separate occasions. Ten
trials were performed for each rotation side. Absolute and variable errors,
processed along their horizontal, vertical, and global components, were used to
assess the cervical joint repositioning accuracy and consistency, respectively.
Mean difference between test and retest with 95% confidence interval, intraclass
correlation coefficient, and Bland and Altman graphs with limits of agreement
were used as statistical methods for assessing test-retest reliability. Results
show that the CRT to NHP when executed in its original form (i.e., 10 trials) has
a fair to excellent reliability (ICC ranged from 0.52 to 0.81 and from 0.49 to
0.77, for absolute and variable errors, respectively); the test-retest
reliability of this test increases as the number of trials used to establish
subject's repositioning errors increases; and using the mean of eight trials is
sufficient to ensure fair to excellent reliability of the measurements (ICC
ranged from 0.39 to 0.78 and from 0.44 to 0.78, for absolute and variable errors,
respectively).
PMID: 18821444 [PubMed - indexed for MEDLINE]
4. Ann Readapt Med Phys. 2008 May;51(4):257-62. doi: 10.1016/j.annrmp.2008.02.004.
Epub 2008 Apr 29.
[Impact of nociceptive stimuli on cervical kinesthesia].
[Article in French]
Vaillant J(1), Meunier D, Caillat-Miousse JL, Virone G, Wuyam B, Juvin R.
Author information:
(1)Centre de recherche et d'innovation en kinésiologie, kinésiopathologie et
kinésithérapie, institut universitaire professionnalisé en ingénierie de la
santé, BP 217, 38049 Grenoble cedex 09, France. JVaillant@chu-grenoble.fr
The goal of this study was to evaluate the impact of nociceptive stimuli upon the
cervical proprioception ability.METHOD: Thirty healthy young subjects performed a
cervicocephalic relocation test (CRT) in two random conditions: the first one was
based on a nociceptive electric stimulation called condition "pain", whereas the
second one was targeting a painless electric condition called condition
"control". The CRT consisted of repositioning the head on the trunk, after an
active transversal movement of the head in the transverse field with closed eyes.
The pointing was recorded at the beginning and at the end of each rotation using
a custom video acquisition system.
RESULTS: The average mean of error repositioning was worth 3.98+/-0.99 degrees
(average mean, standard deviation) in the condition "pain", and 1.75+/-0.37
degrees in the condition "control" (p<0.01).
CONCLUSION: Acute pain provokes a disturbance of the cervical proprioception
ability without damaging the anatomic structure. This observation suggests the
interest of an early follow-up of the pain to avoid sensory disturbances, as well
as the establishment of a cervical proprioceptive rehabilitation program after an
algic event.
5. Phys Ther Sport. 2010 May;11(2):66-70. doi: 10.1016/j.ptsp.2010.02.004. Epub 2010
Mar 15.
Cervical joint position sense in rugby players versus non-rugby players.
Pinsault N(1), Anxionnaz M, Vuillerme N.
Author information:
(1)Ecole de kinésithérapie du CHU de Grenoble, France; TIMC-IMAG laboratory AFIRM
and AGIM3 teams, UMR UJF-CNRS 5525, Grenoble, France. npinsault@chu-grenoble.fr
OBJECTIVE: To determine whether cervical joint position sense is modified by
intensive rugby practice.
DESIGN: A group-comparison study.
SETTING: University Medical Bioengineering Laboratory.
PARTICIPANTS: Twenty young elite rugby players (10 forwards and 10 backs) and 10
young non-rugby elite sports players.
INTERVENTIONS: Participants were asked to perform the cervicocephalic relocation
test (CRT) to the neutral head position (NHP) that is, to reposition their head
on their trunk, as accurately as possible, after full active left and right
cervical rotation. Rugby players were asked to perform the CRT to NHP before and
after a training session.
MAIN OUTCOME MEASUREMENTS: Absolute and variable errors were used to assess
accuracy and consistency of the repositioning for the three groups of Forwards,
Backs and Non-rugby players, respectively.
RESULTS: The 2 groups of Forwards and Backs exhibited higher absolute and
variable errors than the group of Non-rugby players. No difference was found
between the two groups of Forwards and Backs and no difference was found between
Before and After the training session.
CONCLUSIONS: The cervical joint position sense of young elite rugby players is
altered compared to that of non-rugby players. Furthermore, Forwards and Backs
demonstrated comparable repositioning errors before and after a specific training
session, suggesting that cervical proprioceptive alteration is mainly due to
tackling and not the scrum.
PMID: 20381004 [PubMed - indexed for MEDLINE]
6. Spine (Phila Pa 1976). 2010 Feb 1;35(3):294-7. doi: 10.1097/BRS.0b013e3181b0c889.
Degradation of cervical joint position sense following muscular fatigue in
humans.
Pinsault N(1), Vuillerme N.
Author information:
(1)AFIRM Team, TIMC-IMAG Laboratory, UMR UJF CNRS 5525, La Tronche, France.
STUDY DESIGN: Before and after intervention trials.
OBJECTIVE: To investigate the effect of cervical muscular fatigue on joint
position sense.
SUMMARY OF BACKGROUND DATA: Although fatigue-related degradation of
proprioceptive acuity at lower and upper limbs is well documented, to date no
study has investigated whether muscular fatigue induced at the neck could modify
joint position sense.
METHODS: A total of 9 young healthy adults were asked to perform the
cervicocephalic relocation test to the neutral head position, that is, to
relocate the head on the trunk, as accurately as possible, after full active
cervical rotation to the left and right sides. This experimental task was
executed in 2 conditions of No fatigue and Fatigue of the scapula elevator
muscles. Absolute and variable errors were used to assess the cervical joint
repositioning accuracy and consistency, respectively.
RESULTS: Less accurate and less consistent repositioning performances were
observed in Fatigue relative to No fatigue condition, as indicated by increased
absolute and variable errors, respectively.
CONCLUSION: Results of the present experiment evidence that cervical joint
position sense, assessed through the cervicocephalic relocation test to the
neutral head position, is degraded by muscular fatigue.
PMID: 20075783 [PubMed - indexed for MEDLINE]
7. Arch Phys Med Rehabil. 2008 Dec;89(12):2375-8. doi: 10.1016/j.apmr.2008.06.009.
Cervicocephalic relocation test to the neutral head position: assessment in
bilateral labyrinthine-defective and chronic, nontraumatic neck pain patients.
Pinsault N(1), Vuillerme N, Pavan P.
Author information:
(1)Laboratoire TIMC-IMAG, UMR CNRS 5525, Grenoble, France.
OBJECTIVE: To determine whether vestibular or cervical proprioceptive information
influence the cervicocephalic relocation test to the neutral head position, by
comparing head repositioning errors obtained in asymptomatic, unimpaired control
subjects with those obtained in bilateral labyrinthine-defective patients and
chronic, nontraumatic neck pain patients.
DESIGN: A group-comparison study.
SETTING: University medical bioengineering laboratory.
PARTICIPANTS: Labyrinthine-defective patients (n=7; mean age+/-SD, 67+/-15 y),
nontraumatic neck pain patients (n=7; 56+/-9 y), and asymptomatic, unimpaired
control subjects (n=7; 64+/-12 y).
INTERVENTIONS: Participants were asked to relocate the head on the trunk, as
accurately as possible, after full active cervical rotation to the left and right
sides. Ten trials were performed for each rotation side.
MAIN OUTCOME MEASURES: Absolute and variable errors were used to assess accuracy
and consistency of the repositioning, respectively.
RESULTS: No significant difference in repositioning errors was observed between
labyrinthine-defective patients and control subjects, whereas nontraumatic neck
pain patients demonstrated significantly increased absolute errors in horizontal
and global components and higher variable errors in horizontal component.
CONCLUSIONS: These findings suggest that the vestibular system is not involved in
the performance of the cervicocephalic relocation test to neutral head position,
and further support this test as a measure of cervical proprioceptive acuity.
PMID: 19061750 [PubMed - indexed for MEDLINE]
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effect of pectoralis minor resting length on scapular kinematics in subjects with shoulder pain
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Check out a few studies by Borstad et al around 2006.
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This is a question for people doing demographics / symptom assessment research: My team is using several instruments to quantify patient symptoms (Neck Pain Disability Index, McGill Short Form Pain, DASS 21). Right now we have patients fill them out on paper forms. My question is: if we convert these forms to be collected on a computer (e.g. with check boxes), can we compare our results to those collected by other researchers using the same forms collected on paper? I am not sure if it is ok to assume the responses would be equivalent.
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Dear Bryn,
Even slight changes to the original questionnaire (e.g. visual appearance, layout) may affect its measurement properties and participants' responses.
You may find useful information on this topic in Dillman, D.A., Christian, L.M. (2005). Survey Mode as a Source of Instability in Responses across Surveys. Field Methods, 17(1), 30-52.
I would suggest you to check the comparability of your computer and paper-based surveys within a pilot study, before you fully implement the computer-based assessment.
Even if the two survey modes do not show perfect agreement, your pilot study may provide you reasonably accurate conversion equations.
Cheers,
Zeljko
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At the Department of Neurology and Neurosurgery of Peoples’ Friendship University of Russia in Moscow from 1980 we apply intraosseous blockades for the treatment of different neurological pain syndromes such as: low back pain and neck pain, failed back surgery syndrome, facial pain and headache, vertebrogenic cardialgia, neuropathic pain, pain and spasticity in multiple sclerosis, complex regional pain syndrome, pelvic pain, phantom pain, pain and spasticity after stroke, etc. In all these diseases intraosseous blockades showed high therapeutic efficiancy and without complications. Has someone already applied intraosseous blockades for the treatment of pain in the United States or Europe?
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Do you think (believe) that the discogenic theory of  low back pain is real?
Our theory is supported by the high percentage of effective treatment of intraosseous blockades, no complications, and low cost of the procedure.