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Neck / Headaches

Whiplash

whiplash1-ligament-flavDiagnosis: Whiplash is an injury to the cervical region due to an uncontrolled, forceful back to front motion of the neck, similar to the motion of cracking a whip. This rapid movement has the potential to injure the vertebrae, intervertebral discs, muscles, ligaments, nerves, and other soft tissues of the neck. It may often be referred to as a neck sprain or strain, however these are umbrella terms that house additional neck injuries.

Causes: Whiplash is most often caused by automobile accidents, most specifically rear end collisions. However, it can be the result of any forceful trauma including physical abuse or sports injuries.

Symptoms: The most common signs and symptoms of whiplash include neck pain, reduced available motion, and onset of headaches. Symptoms usually surface within 24 hours and might also present with:

  • Neck stiffness
  • Increased pain with neck movement
  • Pain in the shoulder, upper back or arms
  • Numbness and/or tingling in the shoulders, arms, and hands
  • Fatigue
  • Dizziness

It is important to see your doctor if you experience any neck pain or other whiplash symptoms following a car accident, sports injury or other traumatic injury in order to obtain and accurate diagnosis and rule out other injuries. Most people with whiplash recover within a few months after a course of pain medication, exercise and other treatments.

Our Physical Therapy Treatment: Goals of physical therapy will ultimately be to reduce pain, restore normal pain free range of motion, and allow for a safe return to all functional and leisure activities. Length of treatment and plan of care will depend on the severity of the injury, but will most commonly include:

  • Soft tissue mobilization
  • Mechanical diagnoses/treatment for improved movement and pain reduction
  • Postural education and awareness
  • Cervical stability and strengthening exercises
  • TENS unit for pain control

Spinal Stenosis

SpinalStenosis_LGDiagnosis: Spinal stenosis is a narrowing of the canals within your vertebrae, which can cause compression of the spinal cord and nerves traveling through the spine or narrowing of the foramina where a single nerve exits the spine.

Symptoms: Some people with spinal stenosis have no signs or symptoms, while in others it may cause pain, numbness, decreased muscle strength, and possible bowel and bladder problems. Symptoms often vary depending on location, but typically worsen over time. Spinal stenosis is typically less painful in the morning and gradually worsens throughout the day.

Causes: Although some people with spinal stenosis are born with a small spinal canal, it is most typically caused by age related wear and tear of the spine. Some examples of causes that result in decreased available space of the spinal canal include:

  • Overgrowth of bone/bone spurs
  • Herniated disks
  • Thickened ligaments
  • Tumors
  • Spinal trauma

Our Physical Therapy Treatment: Goals of physical therapy will ultimately be to teach the patient techniques for pain reduction allowing increased ability in performance of functional activities.

  • Mechanical diagnoses/treatment for improved movement and pain reduction by opening up space in the narrowed joint.
  • Postural education and awareness
  • Cervical stability and strengthening exercises
  • Balance and mobility training
  • Functional activity training

Spondylosis

SpondylosisDiagnosis: Cervical spondylosis refers to wear and tear of cervical disks in the spine. As people age, discs begin to dehydrate and signs of arthritis develop, such as bony prominences on the edges of the vertebrae. It is a common diagnosis and tends to worsen with age.

Symptoms: For many people, cervical spondylosis is present without symptoms. Apparent symptoms might include pain and stiffness of the neck.

In other cases, spondylosis might result in narrowing of the canals the spinal cord and nerve roots pass through to connect to the rest of your body. If the spinal cord or nerve roots are pinched due to decreased space, symptoms might include:

  • Numbness, tingling, and/or weakness of extremities
  • Difficulty walking with decreased coordination
  • Bowel and bladder symptoms

Causes: General aging results in wear and tear of the spine resulting in:

  • Dehydrated discs: Discs act as cushions supporting each vertebrae of your spine. As we age, discs begin to dry out resulting on increasing bone-on-bone contact between the vertebrae.
  • Herniated discs. The exterior of the spinal discs are also affected by age. They can crack which leads to disc bulging (herniation). This can sometimes push on the nerve roots causing symptoms further down the extremities.
  • Bone spurs. Disc degeneration can result in increased amounts of bone formation in an attempt to strengthen the spine. Such bone spurs can sometimes pinch off the spinal cord and nerve roots.
  • Stiff ligaments. Ligaments, tissue in a cord formation that connects bone to bone, can stiffen with age. This might limit range of motion making your neck less flexible.

Our Physical Therapy Treatment: A physical therapist will diagnose the contributing factors toward spondylosis and develop a treatment plan to address such problems. Treatment is dependent on the individual and the severity of spondylosis, however it might include:

  • Mechanical diagnoses/treatment for promotion of improved movement and pain reduction
  • Postural education and awareness
  • Cervical stability and strengthening exercises
  • Traction

Facet Joint Disorders

facet_imgDiagnoses: Facet joints are joints of the vertebrae where they articulate. They provide stability without compromising flexibility of the neck. Facet joints permit motion by sliding on one another over a moist cartilage that provided lubricant for the joint. Often times with age, this cartilage can become worn out resulting in degenerative changes or “arthritis” of such joints:

Symptoms: Symptoms vary from person to person, depending on the severity and progression of the disorder. With increased levels of friction, the facets may become inflamed resulting in possible secondary responses of:

  • Decreased available motion
  • Surrounding muscle spasm
  • Impaired posture
  • Point tenderness
  • Radiating symptoms into the upper back, shoulders, or arms

Causes: General aging resulting in wear and tear on the spine and cartilage between the joints may cause such inflammatory responses. Other contributing factors might include years of impaired posture or repeated traumatic injuries such as those resulting from contact sports.

Our Physical Therapy Treatment: Physical therapy treatment will be patient specific and dependent on the severity of the disorder as well as the patient’s goals. Treatment will focus on:

  • Mechanical diagnoses/treatment for improved movement and pain reduction
  • Postural education and awareness
  • Cervical stability and strengthening exercises
  • Functional activity training

Patients will be provided education on how to manage symptoms independently in the future. Goals will be to develop a home exercise program allowing for continued gains and understanding of how to help themselves with their symptoms in the future.

Ray, C. (2002, December 10). Treatment Options for Facet Joint Pain. Retrieved April 20, 2015, from http://www.spine-health.com/conditions/arthritis/treatment-options-facet-joint-pain

Cervicogenic headaches

MigraineDiagnoses: Cervicogenic headache is a syndrome characterized by one sided or two sided head pain that is caused by either bony or soft structures of the neck. These headaches need to be differentiated as they can result from other disorders.

Symptoms: Symptoms might very from person to person and be dependent on the severity of the disorder. Some symptoms might consist of:

  • Onset of head pain following a specific or prolonged neck positioning like sitting at computer.
  • Onset of pain following external pressure on symptomatic side
  • Decreased neck range of motion
  • Symptoms in the neck, upper back, shoulder, or arm
  • Muscle tenderness

Less common symptoms include:

  • Nausea
  • Dizziness
  • Blurred vision
  • Difficulty swallowing
  • Same sided swelling

Causes: Cervicogenic headaches often occur from a previous head or neck injury however may also be present without experience of trauma. They can be related to postural impairments resulting in degeneration of the spine over time, causing underlying impairments with cervical bony or soft structures.

Our Physical Therapy Treatment: Treatment will focus on obtaining full cervical range of motion and pain relief. Individual goals of each patient will be addressed and incorporated into their program. Treatments might include:

  • Mechanical diagnoses/treatment for improved movement and pain reduction
  • Postural education and awareness
  • Traction
  • Manual mobilizations

Disc Herniation with resulting arm pain

laminotomy2Diagnoses: A herniated disc (bulging disc) refers to a problem with the cushion-like structure found between the vertebrae. The spinal disc consists of a soft center encompassed by a tough exterior, similar to a jelly donut. Herniations occur when cracks in the outer layer allow the softer “jelly” portion to push through the exterior layer. This can irritate the surrounding nerves resulting in radiating symptoms down the arm.

Causes: Disk herniation is most typically caused by general wear and tear termed disc degeneration. With age, discs tend to gradually lose water contact, making them less flexible and more prone to injury. It can be difficult to peg the cause of a herniated disc, but is sometimes related to putting extra stress on the back, such as turning or twisting while lifting.

Symptoms: In some cases, herniated discs may cause no symptoms and their existence might be unknown. In other cases, symptoms might include:

  • Neck or arm pain
  • Numbness and tingling in the arm or hand
  • Arm or hand muscle weakness
  • Headaches

Our Physical Therapy Treatment: Physical therapy treatment will be dependent on the patient and their response to exercise. Treatment might include:

  • Mechanical diagnoses/treatment for improved disc placement and pain reduction
  • Postural education and awareness
  • Traction
  • Manual mobilizations
  • Soft tissue mobilizations
  • Cervical stability and strengthening exercises
  • Functional activity training

Goals of therapy will be to provide the patient with enough knowledge to independently treat this condition in the future, as well as provide a home exercise plan to lessen likelihood of reoccurrence.

Diseases and Conditions. (n.d.). Retrieved April 20, 2015, from http://www.mayoclinic.org/diseases-conditions/