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Common Neck Problems Seen In Clinics

December 28, 2008

Musculoskeletal Consumer Review took an opportunity to sit with Dr. Razmi Rahmat, a Consultant Spine and Orthopaedic Surgeon from Centre For Spine and Orthopaedic Surgery to discuss about the common neck problems seen in his clinic and the management for those problems.

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Written by cg · Filed Under Cervical, Featured, Spinal Conditions, Workplace Health | Leave a Comment 

Whiplash - Part II

December 6, 2008

In the earlier post on Whiplash - Part I, we looked at what whiplash is all about and the associated signs and symptoms. The treatment options were also discussed briefly. The quality of each of the treatment techniques can be viewed here.

Written by sh · Filed Under Cervical, Spinal Conditions, Spinal Conditions | Leave a Comment 

Whiplash - Part I

August 13, 2008

In this article, we will be looking at the three most commonly asked questions:

  1. What is a whiplash?
  2. What are the signs and symptoms of a whiplash injury?
  3. What are the common treatment techniques available?

What is a whiplash?

Whiplash is a common term for sudden acceleration-deceleration forced on the neck. This is usually as a result of rear-end or side impact motor vehicle accidents or any other mishaps. The acceleration-deceleration forces cause the head into forward flexion (head down position) and very quickly the head gets whipped back into extension (head in a looking up position).

When this occurs, the forces may result in bony or soft tissue injuries such as in the disc, ligaments, tendons, neck muscles and nerve roots.

There are several grades to the severity of whiplash associated disorders (WAD).

Grade 0: No pain or discomfort. No physical signs of injury.

Grade 1: Neck pain, stiffness or tenderness. No physical signs of injury.

Grade 2: Neck pain, stiffness or tenderness. Some physical signs of injury such as point of tenderness or trouble turning the head.

Grade 3: Pain, stiffness or tenderness and neurological signs of injury, such as changes to the reflexes or weakness in the arms

Grade 4: pain and fracture or dislocation of the neck.

What are the symptoms?

The most common symptoms after a whiplash injury are neck pain or stiffness. This can occur immediately after the injury or even after a few days.

Other symptoms may include

  • Headache
  • Pain in the shoulders and arms
  • Dizziness
  • Altered sensation, pins and needles, numbness in the arms
  • Weakness
  • Visual and auditory symptoms
  • Difficulty concentrating
  • Difficulty in swallowing

What are some treatments available for treatment of whiplash?

There are many treatments available for the treatment of a whiplash injury. In this article, we will only list what is available but not grade the quality of each treatment techniques. This will be done in the next article.

Some of the treatments include:

Treatment

What it means

  1. Act as usual

Staying as active as possible within tolerable levels.

  1. Active treatment

Actively perform repeated movements of the neck in a pain free range.

  1. TENS machine

The current from the TENS (transcutaneous electrical nerve stimulation) machine may inhibit pain in the tissues surrounding the electrodes. It works by distracting your nerves and brain from the pain sensation.

  1. Exercise

Exercise improves pain, range of motion, flexibility, function and physical fitness. It is thought that exercise promotes the production of endorphins, naturally occurring hormones by the brain that can help with pain control.

  1. Manipulation

Also known as ‘adjustment’ or ‘cracking’. It is thought that manipulation of a spinal joint may provide temporary increase in joint range of motion. It also corrects spinal alignment which gives relief from musculoskeletal pain.

  1. Mobilization

A technique that entails gentle, controlled movements of the joints affected. This aims to improve mobility in areas of the spine which leads to a decrease in restriction. Hence, removes a source of pain and provides symptomatic relief.

  1. Pilates

Aims to selectively increase the strength and endurance of the deep core muscles of the torso. By doing so, posture and stability is improved, reducing the amount of pressure on the spine.

  1. Acupuncture

A treatment modality of Traditional Chinese Medicine (TCM). Acupuncture influences the nervous system and neurotransmitter which respond to needling stimulation and electro-acupuncture, which in turns influences pain relief. From a TCM perspective, acupuncture is thought to restore the flow of “chi” through the body.

Written by MCR · Filed Under Cervical, Spinal Conditions, Spinal Conditions, Treatment Options | 1 Comment 

Medical Animation - Cervical Radiculopathy

August 1, 2008

Written by MCR · Filed Under Cervical, Video | Leave a Comment 

Memory Foam Pillows - The Basics

June 7, 2008

Memory foam pillows are increasingly common these days with seemingly lower and lower prices. With an overflow information, consumers are getting confused between various manufacturer claims. So what are memory foam pillows? Read more

Written by MCR · Filed Under Cervical, Ergonomics, Lumbar, Spinal Conditions | Leave a Comment 

Office initiative reduces headaches and neck and shoulder pain by more than 40 percent

May 17, 2008

Office staff who took part in an eight-month workplace initiative reported that headaches and neck and shoulder pain fell by more than 40 per cent and their use of painkillers halved, according to research published in the May issue of Cephalalgia.

They also reported that pain levels were less severe at the end of the study than at the start. Read more

Written by Admin · Filed Under Cervical, Ergonomics, Workplace Health, Workplace Health News | Leave a Comment 

Neck-Related Headaches

April 3, 2008

Have you ever had the feeling that your headache is somehow related to the pain in your neck?  How that it is such a coincidence that every time your headache is preceded by the stiff neck that you are experiencing?  You are not imagining it! It is what the medical community calls cervicogenic headaches, which means headaches originating from the neck

What are the usual complaints from people who suffer from cervicogenic headaches?

Most sufferers complain of a deep dull ache starting from the base of the skull to the top of the head, usually over just one side of the head.  It may be present on both sides if the neck pain and stiffness are on both sides of the neck.  Other complaints include feeling pressure at the back of the eye and discomfort in the jaw. 

Nerves to the Head

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Another symptom that confirms the diagnosis is the presence of tenderness when pressure is applied over area of the cervical spine immediately under the skull.  In some cases, when pressure is applied for long enough, sufferers feel some relief from the headache.

What are some of the activities that aggravate this condition?

Typically, activities that require the neck to be in a sustained strained position for a prolonged period of time will aggravate this problem.  The neck posture is often faulty, the head is turned or tilted to one side or sufferer is adopting the “poke chin” position.

Example of such activities including reading, using the computer especially the laptop, putting on make up, looking up for too long or watching movies or theatre when seated on the side of the hall.

Why do these activities aggravate the headache?

When we adopt the “poke chin” posture, we apply compressive stress to the upper part of the cervical spine, namely, C1 and C2 levels (C1/C2 refers to the first two cervical vertebrae in the spine).  Similarly, when we turn our head to one side, we compress the C1-2 level on the same side.  This happens as most of the movement of the head occurs at these 2 spinal levels.   So if we sustained these postures or repetitively perform them, these 2 levels will start to degenerate and the cartilage wears out over time. This in turn results in stiffness of the upper cervical spine.

What is relevance between the C1-2 levels and headaches?

C1-2 Nerve Compression

dth=”230″ height=”230″ border=”0″ src=”/wp-content/uploads/2008/04/c1-2-nerve-compression.jpg” alt=”C1-2 Nerve Compres

The nerves that exit C1-2 and sometimes C3 supply sensation to the back of the skull to the top of the head and in some people to the jaw area.  The nerves that exit from the right side of the neck will supply only the right side of the head, likewise for the left.

When these joints are stiff or mal-aligned, the nerves at the affected levels will be irritated causing pain. So when one has a right-sided upper neck pain or stiffness, the pain is always referred to the right side of the head.

What can we do?

We need to improve the cervical joint alignment and mobility at the C1-2 levels and to remove the compressive forces, which is to adopt good posture. This will reduce the irritation to the nerves.

If the cervical facet joints are slightly rotated due to contractile forces of tight muscles surrounding the neck, the affected joints are already in some amount of compression and may not allow full functional or physiological range.  In this situation, physiotherapists can apply the “MUSCLE ENERGY TECHNIQUE” to realign the joint position.  This technique uses the muscles to reposition the joint.

Once the joint is in a neutral position, the actual stiffness (hypomobility) can then be accurately assessed.  Stiffness can be treated by various techniques, such as passive mobilization through the MAITLAND technique or with the clients’ active movement with the MULLIGAN SNAG technique.  If the joints remain stiff even after a few sessions of mobilization, MANIPULATION can be applied.  Once the ideal mobility has been achieved, the client will be expected to maintain it by self mobilization with a strap.

Once the mobility is improved, the headache will be resolved.  The client can remain pain free for a long time provided the original cause of poor posture is solved.  Good ergonomics here is paramount.
 

 

 

Written by MCR · Filed Under Cervical | 1 Comment 

Does Bad Posture Lead to Scoliosis?

March 6, 2008


click for larger view
Scoliosis or better known as abnormal curvature of the spine typically curves into a ‘C’-shape or ‘S’-shape when look at from the back. Since your back is curved and you tend to tilt to one side or one of your shoulders could be lower than the other, a common question pops up, "If I have poor sitting posture where I tend to lean on something, will I develop scoliosis?". Read more

Written by cindy.tan · Filed Under Cervical, Lumbar, Spinal Conditions, Thoracic | Leave a Comment