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Neck Pain

 
  Neck Pain:
 
Neck pain  is a very common pain complaint in many households.  It can occur from sleeping on a hard surface in an awkward position, work, or a traumatic incident,a recent fall or being in a low to high impact motor vehicle collision. The severity of the pain can range from mild pain to relentless, or excruciating pain. It can cause severe disability, time away from work and many precious hours away from our children and grandchildren due to pain from repetitive neck rotation, carrying,  lifting the children  while playing with them.
 
 Recieving the  correct diagnosis and initiating the right type of treatment  is vital to your recovery.That is why an evaluation and treatment from a Physiatrist (PM&R) is your best bet for returning you to optimum health. In addition to a thorough evaluation  the medical doctor will creat a customized program that may include medications, heat, ice, massage, stretching and strengthening exercises and in some cases therapeutic trigger point injections to limit  futher aggravation and to  heal your pain.
 
Some of the common causes of  neck  pain includes:
  • Spondylolisthesis-"spondlo" means vertebre and "olisthesis" means sliding on a slippery surface. typically there  is slipping of one vertebre on another vertebre causing neck pain and the possible compression of nerve roots which can lead to radicular arm pain 
  • Radiculopathy - A pinched nerve, usually from a herniated, or slipped, disk. Patients tyically  complain of numbness/tingling /or a  shooting pain traveling down the arm or mid back  which is very severe and needs to be evaluated further with diagnostic testing(MRI/NCV and EMG)

  • Myofascial Pain -  is a sore , aching pain in muscles that's due to microtrauma to muscles and usually manifest  as a trigger point(tender to the touch ). This type of pain can occcur due to deconditioning(inactivity),poor posture, sitting at a computer, performing manual labor while working in the yard,gardening,  repetive bending or lifting. Patients can also have referral pain down the arm.

  • Spinal Stenosis - A narrowing of the nerve openings either around the spinal canal or nerve roots that can cause symptoms similar to a pinched nerve. It can cause arm pain in anyone, but most often does so in older people. Patients with spinal stenosis can have trouble walking, and standing and pain relief with  sitting down or bending forward. It can cause aching or heaviness in either extremity.

  • Tendon, Ligament and Soft Tissue Pain - Localized pain when an area is stretched or its muscles are overused. This results in tenderness.
  • Scoliosis -also known as a curved spine causes muscle imbalance and poor posture which can lead to neck pain
  • Non-Spinal Causes of neck pain- Pain  imitating a neck injury, but from another cause.  tumors,syrinx,parathyroid disease, arteriovenous malformations are a few examples of problems that can refer pain to the back.

Treatment Options:
The rehabilitation of neck problems occurs in several phases. During the acute phase, physiatrists will perform  a detailed and comprehensive evaluation to ensure the diagnosis. the doctor will order the appropriate daignostic test and order blood work if necessary. he will provide the patient pain medications and develop a physician supervised treatment plan to treat the pain and inflammation. Treatment options are varied but may include ultrasound, moist heat & electrical stimulation, masage ,hydrobed,  neck mobilization, medication, and even specialized injections.
In the sub-acute phase or recovery phase of treatment, The physiatrist attempts to improve flexibility and strength by implementing a structured and medically supervised stretching and strengthening exercise program aimed at decreasing pain and improving quality of life. The goal of this phase is to get you back to your usual work,  and leisure activities.
The main goal of the third phase of treatment, the maintenance phase, is to minimize recurrence of the problem and to prevent further injury. This often consists of a total body fitness program, designed to maintain body mechanics and increase endurance after the original symptoms have resolved. and a home exercise program to ensure continued pain relief
 


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