Cervial Spine Diagnosis

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Cervial Spine Diagnosis
2011-10-23 22:38:30
Ortho Fall 2011

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  1. Cervial Arthritis
    • the most common cause of neck pain in the elderly
    • body mechanics, strech, core, modalities, strengthening
  2. S&S of Arthritis
    • Symptoms when the osteophytes impinge on a neural or vascular structure
    • Local pain
    • Parethesia - numbness, tingleing
    • Stiffness - not using full ROM
    • Joint crepitance - grinding noise with movement
    • Radicularsymptoms - sharp shotting apin in the neck and arm
    • Loss of Motion
  3. Treatment for Cervical Arthritis
    • use modalities and massage for symptomacitc relief
    • prescribe active fpain free neck exercises and prgoress to resistvie isometric exercises
    • Teach pt to self stretch the upper trapexius, levator scapulae,and pectoral muscles
    • Teahc the importance of correct head posture
  4. Muscle Strain
    • Can occur with flexion or extension trauma
    • Can occur from postural strain from prolonged sitting posture
  5. Symptoms of Muscle Strain / Whiplash
    • Neck shoulder, and back pain
    • Nech stiffness
    • Concentration and memory problems
    • Dizziness
    • Insomnia
    • Depression and anxiety
    • Not always dianosed correctly,may have underlying fracture
  6. Whiplash from extension
    • Head rapidly accelerates into extension and occiput is stopped by thorax
    • posterior structures compresed and anterior structures stretched
  7. Whiplash from Flexion
    • Head rapidly accelerates into flexion with chin stopped by sternum
    • Posterior stretched anterior compressed
  8. Important Rehab Considerations for Whiplash
    • Do no traction - may have fracture
    • Avoid passive stretching of head and trunk - already overstretched
  9. Acute phase whiplash treatment
    • 2-3weeks
    • Modalities for pain
    • collar for support
    • AROM exercises without pain - sidebend rotation
    • Educate pt about possture
    • find position of comfort (shortened)
  10. Controlled Mobility Whiplast treatment 2-10 weeks
    • Restore flexibility
    • Restore optimal posture- lordosis
    • AROM exercises
    • Grade 2-3 joint mob without pain
    • Identify position bais, choose exercises in direction of comfort
    • Modalities as needed
    • Do motions short of symptoms
  11. Return to function whiplash treatment 10 weeks to 12 months
    • Emphasis is on strengthening and posture
    • Increase strngthening exercises
    • Posture education
    • Functional activities
    • Modalilies only in necessary
  12. Facet Joint Issues
    • Will have protective posture - SB/rotation to the same side
    • Canbe locked into a position and have pain and restriction with SB and rotation in opposite direction
    • Pain may follow dermatomal patho
    • no true neruoligical signs
    • Palpation of single semgent will be painful
    • Will have muscle gaurding
    • Most Common site is C5
  13. Acute Facet Joint Treatment
    • Identify position of comfort
    • Passive positioning - often will have flexion bias
    • Modaliaties
    • Traction
    • Self Traction
    • Isometric Exercises
  14. Controlled Mobility Facet Joint Treatment
    • Modablities as need
    • ROM activities into prain free movement - move toard position of comfort andthen gradually work on moving in opposite direction
    • Joint mobs
    • Stabilization exercises
    • Pt ed
  15. Return to Function phase for Facet Joint Treatment
    • Emphasis on strenthening
    • AROM to resisted ROM
    • Posture ed
    • Functional Activities
  16. Symptoms of Nerve Root Involvement
    • Gradual worsening of symptoms starting with central pain at the base of the neck and spreading to shoulder and arm and may refer to upper thoracic spine
    • Interscapular pain corresponding to clowards signs
    • Later can have psitive neuro signs appear
    • Posture- slumped posture with forward head. Extension or correct posture can increase peripheral signs and symptoms if protrusion is too large to be reduced
  17. Disc Pathology Common Sites
    • Less grequently in lumbar
    • Most common C5-6
    • Caused by DDD,DJD
    • May need CT scan to diagnose
  18. Disc Pathology Diagnosis
    • x-rays usually are noraml or how very slight narrowing - DDD, DJD, will show more changes on x-ray
    • Specal Tests
    • CSpine flexion with compression = + HNP
    • CSpine extension with compression = nerve root problem at neural foramen
  19. Important Rehab Considerations for Disc Disorders
    • Isometric exercises held secondary to increaseing disc pressure
    • Avoid rotation exercises in early stages
  20. Treatment of Acute Disc
    • Bed rest if severe, walking
    • Passive axial extension/ cervical retraction- supine no pillow,do a midline head nod
    • Pt ed - passively retract in sitting by pushing against chin, position of comfort, passive positioning
    • Traction - sustained or oscillatory
    • Gental Joint Mobs
    • Posture Ed
    • Cervial Collar/ support if needed
  21. Controlled Mobility treatment for Disc problems
    • Correct posture
    • Dynamic stabilization exercises for posture control - emphasis on shoulder and scapular muscles
    • Aerobic exercise
    • Environmental adaptations to decrease postural stress
    • Initiate function activities
  22. Return to Function Treatment for Disc Problems
    • Progress strengthening during this stage - empasis on upper trunk and core
    • Continue postural training
    • Functional Activites with safe spinal mechanics - emphasis on repetitive tasks
    • Pt ed to revention of reinjury