This is caused by an acute cervical disc prolapse or pressure on the root from spondylotic osteophytes narrowing the root canal. Acute cervical disc prolapse presents with unilateral pain in the neck, radiating to the inter-scapular and shoulder regions. This diffuse, aching dural pain is followed by sharp, electric shock-like pain down the arm, in a nerve root distribution, often with pins and needles, numbness, weakness and loss of reflexes. Cervical spondylosis occurs in the older patient with posterior osteophytes compressing the nerve root and causing root pain, commonly at C5/C6 or C6/C7; it is seen on oblique radiographs of the neck. An MRI scan shows facet joint OA and any associated disc prolapse clearly.
Treatment of cervical disc prolapse
A support collar, rest, analgesia and sedation are used as necessary. They should be advised not to carry heavy items. It usually recovers in 6-12 weeks. MRI is the investigation of choice if surgery is being considered or the diagnosis is uncertain . A cervical root block administered under direct vision by an experienced pain specialist may relieve pain while the disc recovers. Neurosurgical referral is essential if the pain persists or if the neurological signs of weakness or numbness are severe or bilateral. Bilateral root pain is a neurosurgical emergency because a central disc prolapse may compress the cervical spinal cord.
See the other causes of neck pain
Showing posts with label spondylitis. Show all posts
Showing posts with label spondylitis. Show all posts
Friday, April 3, 2009
Causes of neck pain and its treatment
Causes of neck pain and its treatment
Unilateral or bilateral muscular pattern neck pain is common and usually self-limiting. It can follow injury, falling asleep in an awkward position, or prolonged keyboard working. Chronic burning neck pain occurs because of muscle tension from anxiety and stress. Spondylosis seen on X-ray increases after the age of 40 years, but it is not always causal. Spondylosis can, however, cause stiffness and increases the risk of mechanical or muscular neck pain. Muscle spasm can be palpable, is tender and may lead to abnormal neck posture (e.g. acute torticollis). Muscular pattern neck pain is not localized but affects the trapezius muscle, the C7 spinous process and the paracervical musculature (shoulder girdle pain). Pain often radiates upwards to the occiput but rarely laterally to the tip of the shoulder. It is commonly associated with unilateral or bilateral tension headaches; pain radiating over the head to the temple and eye, described as like a pressure or tight band. These features are also seen in fibromyalgia.
Following are list of causes of pain in neck or shoulder:
#Trauma (for example, a fall)
#Mechanical or muscular neck pain
#Whiplash injury
#Disc prolapse - nerve root entrapment
#Ankylosing spondylitis
#Shoulder lesions: Rotator cuff tendonitis Calcific tendonitis or bursitis Impingement syndrome or rotator cuff tear Adhesive capsulitis (true 'frozen' shoulder) Inflammatory arthritis or osteoarthritis.
#Polymyalgia rheumatica
#Fibromyalgia
#Chronic (work-related) upper limb pain syndrome
#Tumour
Treatment of neck and shoulder pains:
Patients are given short courses of analgesic therapy along with reassurance and explanation. Physiotherapists can help to relieve spasm and pain, teach exercises and relaxation techniques, and improve posture. An occupational therapist can advise about the ergonomics of the workplace if the problem is work-related.
Unilateral or bilateral muscular pattern neck pain is common and usually self-limiting. It can follow injury, falling asleep in an awkward position, or prolonged keyboard working. Chronic burning neck pain occurs because of muscle tension from anxiety and stress. Spondylosis seen on X-ray increases after the age of 40 years, but it is not always causal. Spondylosis can, however, cause stiffness and increases the risk of mechanical or muscular neck pain. Muscle spasm can be palpable, is tender and may lead to abnormal neck posture (e.g. acute torticollis). Muscular pattern neck pain is not localized but affects the trapezius muscle, the C7 spinous process and the paracervical musculature (shoulder girdle pain). Pain often radiates upwards to the occiput but rarely laterally to the tip of the shoulder. It is commonly associated with unilateral or bilateral tension headaches; pain radiating over the head to the temple and eye, described as like a pressure or tight band. These features are also seen in fibromyalgia.
Following are list of causes of pain in neck or shoulder:
#Trauma (for example, a fall)
#Mechanical or muscular neck pain
#Whiplash injury
#Disc prolapse - nerve root entrapment
#Ankylosing spondylitis
#Shoulder lesions: Rotator cuff tendonitis Calcific tendonitis or bursitis Impingement syndrome or rotator cuff tear Adhesive capsulitis (true 'frozen' shoulder) Inflammatory arthritis or osteoarthritis.
#Polymyalgia rheumatica
#Fibromyalgia
#Chronic (work-related) upper limb pain syndrome
#Tumour
Treatment of neck and shoulder pains:
Patients are given short courses of analgesic therapy along with reassurance and explanation. Physiotherapists can help to relieve spasm and pain, teach exercises and relaxation techniques, and improve posture. An occupational therapist can advise about the ergonomics of the workplace if the problem is work-related.
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