I was on the bus, and a woman was complaining bitterly about neck pain, and she was very angry at the fact that she works very hard and was associating her work with the pain. Also, she has had a history of neck pain in the past. Well, as a woman, you have a higher chance of having neck pain than men, also people who have a prior history of neck pains will have a higher risk factor of having it again. Other factors associated with neck pain are age (people older than 40), and having to perform strenuous jobs. I do not know this woman before but from what she said, she is likely to have neck pain as she has a high-risk factor of having it. Other factors include having a history of smoking, age-related diseases, as well as cervical thinning of the disc. People who also do long-sitting jobs in front of the computer will also have neck pain. One other risk factor for having neck pain is having back pain previously. These risk factors can lead to tightened muscles such as the upper trap, suboccipital, scalenes, and levator scapulae. With neck pain, there can be a fear of movement which leads to hypomobility as a result of avoidance. Neck pain has a lifetime prevalence of about 86.8% point and 20% of the adult population suffers from neck pain.
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To be able to treat cervical spine pain (neck pain) you need to be able to classify it. The classification of neck pain are; Neck Pain with mobility deficit, Neck pain with movement coordination impairments (including whiplash-associated disorder [WAD]), Neck pain with headaches (cervicogenic headache), and Neck pain with radiating pain (radiculopathy). Let me explain the symptoms to identify which neck pain a person has.
Neck Pain with mobility deficit is the most common type of neck, and patients will experience unilateral or central neck pain, which is accompanied by a limitation in neck motion. Upper girdle, and the upper extremities can also present with pain. A very good example of this type of neck name is Acute wry neck which occur as a result of sleeping on your neck wrongly. Interventions include Thoracic spine thrust manipulation which helps to reduce the pain in the cervical spine, and the cervical thrust manipulation which is an up sloping rotational cervical rotation. To perform this interventions, the symptoms of the pain should be less than 38 days, the pain should be acute, and should have a cervical rotation range of motion side by side of above 10 degrees.
Neck pain movement coordination impairments is a type of pain that has to a trauma to the head and the neck such as Whiplash Associated Disorder (WAD), post concussive symptoms, other causes that are not traumatic but can fall in this class of neck pain are Vestibular/Dizziness signs and symptoms, and Pesistent neck pain. This is very common with patients who have a trauma in their head as a result of a car accident, heavy falls towards the head or neck. This class of pain can be tested by craniocervical flexion test, deep neck flexor endurance test, and another test would be join position error. Muscle retraining is important in helping the patient get their muscles working back perfectly.
Patients with grade 3 neck pain would be include sensory neckpain such as parasthesia. Patient will have impaired cervical range of motion which is less than 60 degrees which are painful. This rotation can decrease muscle strength, and radiate pain in the arm. It is important to identify if patient is having a neck pain or a shoulder pain as both of them overlaps. If the patient's pain reduces by abduction and placing of the pain over the head, then it is a cervical or neck pain. In the case of disc herniation, the patient will feel the pain from the neck to the arm. With Radiculopathy, the pain also goes to the arm. It occurs as a result of the cumpression of a nerve root by the disc in disc herniation. It occurs at C6 and C7, and it can also be at C5 compressing the nerve.
Diagonising grade three neck pain starts with examining the biceps and triceps reflex,examining the range motion, movement that provoke and reduce pain in the neck. When it comes to treatment, Acute low grade pain episodes can resolve spontaneously and physiotherapy can also be done. In severe cases, spinal fusion can be performed, also artificial disc replacement can be done.
Reference
https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-021-04957-4
https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Neck-Pain
https://pubmed.ncbi.nlm.nih.gov/21665126/
https://www.jospt.org/doi/10.2519/jospt.2017.0302
https://www.physio-pedia.com/Epidemiology_of_Neck_Pain
https://www.physio-pedia.com/Neck_Pain:_Clinical_Practice_Guidelines