Neck and Cervical Problem

1. Neck Cervical Problems:

The condition also known as the arthritis of neck, is usually described as the result of degeneration of the intervertebral discs in the cervical spine.
It may be also caused by bony overgrowth which results in pinching of the adjacent nerve roots, physical inactivity, disc herniation, ligamentous instability, traumatic injury, as a result of overuse injury, history of faulty posture, or prolonged immobilization after injury

Possible Characteristics:

Cervical pain aggravated by movement like coughing/ sneezing/ moving neck backwards or rotation of neck , referred pain over the shoulder blade, cervical stiffness, numbness or tingling sensation down the hand or muscular weakness in upper limb, dizziness or vertigo, frequent headaches and may be poor balance.
In some cases this degeneration leads to posterior protrusion of the annulus fibres of the intervertebral disc. Protrusion can cause compression of the nerve roots, motor disturbances, muscular weakness.

Treatment-

Electrotherapy modalities
Cranio-osteopathy
Specific manual therapy techniques
Soft tissue manipulation
Nerve stretching
Core muscle strengthening
Postural ergonomics
Functional re-education

2. CERVICAL STENOSIS:

Cervical stenosis occurs when the spinal canal narrows and compresses the spinal cord or the nerve roots, and is most frequently caused as a result of aging or bony overgrowth.
The space between the vertebrae shrinks and the discs lose their ability to act as shock absorbers. At the same time, the bones and ligaments that make up the spine become less pliable and thicken resulting in wear and tear of the cartilage.
Common symptoms include neck or arm pain, numbness or tingling sensation in hands, muscular weakness, unsteady gait when walking, loss of coordination, poor reflexes, bladder and bowel incontinence or even paralysis if left untreated.

Treatment-

Electrotherapy modalities
Postural re-education
Strength and flexibility training
Gait training
Balance training
Manual therapy techniques

3. CERVICAL NERVE ROOT IMPINGEMENT:

Causes-

Spinal stenosis
Disc herniation (C5-C6 or C6-C7 are most common)
Chronic muscular tension/ facet joint syndrome
Ligamentous instability
Traumatic injury

Symptoms-

Radiating pain in the upper extremity (shoulders, arms, forearms or hands)
Sharp, shooting pain increased at night
Pain over the shoulder blade
Trapezius spasm
Numbness/ tingling sensation in one or both hands
Vertigo or dizziness
Frequent headaches
Motor weakness

Treatment-

Electrotherapy modalities
Soft tissue manipulation
Neuro-dynamics
Postural re-education
Core rehabilitation
Manual therapy techniques

4. SPRAIN/STRAIN SYNDROME:

Inflammation from sprain (ligaments) /strain (muscles) may irritate nerve roots in close anatomical orientation to affected area and may produce neurological symptoms.
Strain to the posterior cervical , scapular, and upper thoracic muscles and fascia is common with postural stresses such as prolonged sitting at a computer terminal.
It results in painful neck movements specially rotation or coupling movements. Pain may be referred to shoulder.

Treatment-

Electrotherapy modalities
Cryotherapy
Gentle range of motion exercises
Stretching
Postural ergonomics
Functional rehabilitation

5. COMPRESSION FRACTURE:

Any excessive compression loads usually causes end-plate or vertebral body fractures resulting in reduced vertebral height. Pain may occur with or without nerve root involvement, there may be referred pain in the extremities.
In some cases, the fracture may lead to paralysis.

Treatment-

Electrotherapy modalities
Gentle isometric exercises
Postural ergonomics
Functional re-education

6. FACET JOINT/ JOINT CAPSULE INJURY:

This usually occurs after any kind of trauma like falling or a motor vehicle accident.

SYMPTOMS:

Joints swelling (effusion)
Limited range of motion
Muscle guarding (spasm)
The swelling may cause foraminal stenosis and neurological symptoms.
Persisting point tenderness
Painful neck movements
Morning stiffness

Treatment-

Electrotherapy modalities
Cervical manipulation
Rehabilitation protocol
Strength training
Postural re-education

7. VERTIGO

Vertigo is being disoriented or a feeling of head spinning around, swayed or being pulled in one direction while the person is standing or sitting still. It is often a complication of cervical spondylosis where the C1 & C2nerve roots which supplies the brain gets pinched resulting in compromised blood flow to the brain.
It may be accompanied by nauseating feeling, dizziness, abnormal or jerking eye movements, frequent headaches.

Treatment-

Cervical manipulation
Cranial osteopathy
Postural ergonomics
Functional rehabilitation

8. UPPER CROSSED SYNDROME

It is a result of muscular imbalances in the neck and shoulder region which creates joint dysfunction generally at atlanto-occipital joint, gleno-humeral joint, cervico-thoracic joint, C4-C5 segment, T4-T5 segment. It is mostly found in people who have prolonged sitting jobs, or who work for long hours on computers/laptops. This instability exhibits poor postural changes like forward head posture, increase cervical lordosis (curve) or thoracic kyphosis (hunch-back), elevated or protracted shoulders, rotation of scapula.

Treatment-

Postural correction
Manual therapy techniques
Correct muscular imbalances
Postural ergonomics
Strengthening and flexibility training

9. MECHANICAL NECK PAIN

Mechanical neck pain is often caused by overuse injury of the muscles or the poor posture leading to muscular instability. The pain does not radiate to arms, it remains localised to neck, or shoulders

Symptoms-

Morning stiffness
Painful movements specially bending and rotation
Muscular spasm
Cervicogenic headaches
Heaviness over the shoulder blade
Localised tenderness

Treatment-

Electrotherapy modalities
Soft tissue manipulation
Strength and flexibility training
Mobilisation of cervical spine
Postural ergonomics
Functional rehabilitation

10. TORTICOLLIS

A condition characterised by tightness or spasm of sternocleidomastoid, trapezius and other neck muscles prominent on one side more than other resulting in twisted/tilted posture of neck which gets fixed if left untreated.
It may be a result of trauma, present by birth or due to structural changes. The head appears to be tilted on one side and chin on the opposite side.
It causes muscular tightness, headaches, shoulder pain, uneven shoulder levels, swollen lymph nodes.

Treatment-

Electrotherapy modalities
Heat therapy
Stretching
Manual traction
Strengthening of weak muscle group
Functional re-education

11. TRAPEZIUS SPASM:

Muscular spasm is a result of overuse injury or muscle strain leading to compromised blood flow to that muscle because of stiffness

Symptoms-

Restricted and painful neck movements
Stiffness in neck
Heaviness over shoulders
Pain may extend to mid back
Cervicogenic headaches

Treatment-

Electrotherapy modalities
Stretching
Manual therapy techniques
Ischaemic compression
Postural ergonomics
Cryotherapy
Strength training

12. TEXT-NECK SYNDROME :

Text-neck syndrome also known as facebook-whatsapp syndrome is now-a-days very common caused due to repetitive strain injury or overuse injury. The neck remains hanging down (forwards) looking at the phones or wireless devices for a extended period of time causing neck pain and soreness.

Symptoms-

Mechanical neck pain
Stiffness in neck, shoulders or upper back
Cervicogenic headache
Muscular spasm
Sharp, nagging pain
Cervical Instability
May result in pinched nerve leading to radiating pain down the arms
Poor posture
Straightening of cervical spine

Treatment-

Electrotherapy modalities
Cryotherapy
Soft tissue manipulation
Joint mobilisation
Neck stabilisation exercises
Manual therapy
Strength and flexibility training
Functional re-education
Postural ergonomics

13. STRAIGHTENING OF CERVICAL SPINE

In patients with neck pain, generally instability or biomechanical changes causes loss of normal cervical lordosis resulting in straightening of cervical spine which may affect blood flow to the brain and leads to faster degeneration of the intervertebral discs due to increased weight transfer.

Treatment-

Postural ergonomics
Strengthening protocol
Osteopathic and chiropractic manipulation
Manual therapy techniques
Joint mobilisation
Functional re-education

14. THORACIC OUTLET SYNDROME:

The condition characterised by the compression of the nerves or blood vessels or both between the collar bone (clavicle) and first rib. It may be caused due to repetitive injury or sports injury, pregnancy, anatomical defects like presence cervical rib (extra), heavy weight lifting, tumours in chest or trauma.

Symptoms-

Pain and stiffness in neck and shoulders
Painful movements
Numbness or tingling sensation in arms
Cold extremities
Impaired circulation to extremities leading to discoloration
Weak or no pulse in affected arm
Blood clots in veins or arteries in upper areas of body
Muscular weakness

Treatment-

Electrotherapy modalities
Cervical manipulation
Postural ergonomics
Strength training
Weight reduction
Functional re-education

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