1. INTRODUCTION
Neck pain is a common condition, ranking as the fourth most burdensome disease worldwide. Evidence suggests that rates of recurrence and chronicity are high (Borghouts et al., 1998; Hoving et al., 2001), which results in considerable functional and economic implications (Vos et al., 2012). Joint mobilization (JM) is widely acknowledged as an effective intervention (Childs et al., 2008). However, a Cochrane review indicated that the most effective cervical JM dosage has yet to be determined (Gross et al., 2010). Multiple studies have established a sympatho-excitatory effect resulting from cervical JM (McGuiness et al., 1997; Vicenzino et al., 1998; La Touche et al., 2013). On the contrary, Yung et al. (2014) developed a distinctive dose using anterior-to-posterior pressures (AP) of the cervical spine that resulted in a reduction in systolic blood pressure (SBP) and heart rate (HR), suggesting a sympatho-inhibitory effect. Therefore, it is indeterminate whether cervical JM results in sympatho-excitatory or sympatho-inhibitory effect if the dosage (Yung et al., 2015) is different from the traditional 3 sets of continuous 30-90 second regimen.
Maitland’s (Maitland et al., 2005) unilateral posterior-to-anterior glide (PA) is an entry-level form of JM commonly used by physiotherapists worldwide; and it appears to be more efficacious for pain relief and outcomes in patients with unilateral neck pain compared to other JM techniques such as transverse pressures and
Clinical Topics: ACOEM Pain, Suffering, and the Restoration of Function Chapter guidelines stress the importance of a time-limited treatment plan with clearly defined functional goals, with frequent assessment and modification of the treatment plan based upon the patient’s progress in meeting those goals, and monitoring from the treating physician is paramount. In addition, CA MTUS Acupuncture Medical Treatment Guidelines state that acupuncture can be used to reduce pain, reduce inflammation, increase blood flow, increase range of motion, decrease the side effect of medication-induced nausea, promote relaxation in an anxious patient, and reduce muscle spasm. Furthermore, guidelines state that time to produce functional improvement of 3 – 6 treatments. The patient has chronic neck pain. The latest progress report indicated that the pain is rated 9/10-scale level. Medications and PT have been tried and provided minimal improvement is her pain. The guidelines support 3 to 6 treatments of acupuncture to produce functional improvement. In addition, the latest progress report discussed about continued acupuncture 2X4. It is unclear if the patient has received acupuncture treatment for the cervical spine before. If yes; number of sessions completed to date, functional improvement and pain relief from the prior treatment should be documented. Additional information is required to certify the request. Recommend
Because yoga is a practice that inherently stretches and strengthens muscles and improves posture, it is one your physical therapist may recommend. Yoga International says that the postural awareness yoga practice fosters is effective for lasting relief from a pain in your neck, and offers a few suggestions for yoga poses for neck pain that can be done while sitting in a chair.
Massage is a very common form of therapy for all sorts of things, from stress to chronic pain. There have been numerous studies that demonstrate the effectiveness of massage in helping to manage patients’ pain while keeping them off medication. The benefit of this type of treatment is pain relief through manipulation of the body. The mechanism of action is, once again, unknown, but it is thought to be related to stimulation of muscles and the blood flow being increased. There are
It was noted that the patient has neck pain, facet arthropathy and spondylosis, suggestive of facer joint origin, 80% relief from previous facet nerve injection/block, prior rhizotomy more than 6 months and cervical/thoracic facet medial branch nerve block which has been helpful, failed conservative treatments with nonsteroidal anti-inflammatory medications (NSAIDS), PT, chiropractic care and home exercises.
Cervical Traction (Parameters): Acute/ 1st session- 6 to 10 lbs., static pull, 5 minutes, gradually increase to patient tolerance. Routine Session- 20 to 30 lbs. or 7% of the patient’s body weight, intermittent pull- 15/15, Time: 20 minute. This treatment will distract the joints in the cervical region and help alleviate the pain.
A post hoc-pair-wise comparison test was done to obtain the mean change among the three treatment groups with p values. P values that was greater than 0.5 were considered to be significant for the study. The author found that there were some changes in the participants physical activities where the TENS unit had caused the Fibromyalgia pain to subside where patients were able to have an improved quality of life. The effectiveness of this study does remain controversial due to TENS unit being self-administered by the
Carey reported that she experienced occasional numbness of the upper extremities and that she would occasionally drop objects from both hands. Upon physical examination, Dr. Abiera noted that Ms. Carey’s range of motion of the cervical spine was decreased on flexion and tenderness on palpation of posterior cervical muscles with spasms and trigger points was present. In addition, Dr. Abiera noted that the range of motion of lumbar spine was within normal range, however there was still some tenderness on palpation of thoracic paraspinals muscles.
A physician with a wealth of experience in the fields of anesthesiology and pain management, Dr. Daniel Kendall has served as an interventional pain medicine specialist with National Spine and Pain Centers for 17 years. He treats patients out of National Spine and Pain’s Arlington location near his home town of Vienna, Virginia. Before assuming his current position, Dr. Daniel Kendall served as chief fellow of pain management at Johns Hopkins Hospital in Baltimore, Maryland. His experience with Johns Hopkins included training in advanced modalities such as sympathetic blocks, vertebroplasty, intrathecal pumps, IDET, radiofrequency ablation, and spinal cord stimulation.
1. Cervical adjustment: It is the manual treatment for the people suffering from neck and shoulder pain. The practitioner stimulate the joints position to improve the functioning of the nervous system.
DOI: 6/23/2015. Patient is a 44-year-old male assembler who sustained injury while he was reaching for a part, pulled axle from rack and felt pain in the cervical spine. Per OMNI, the patient is diagnosed with acute cervical sprain and cervical radiculopathy.
S: TM completed total of 28 ESI visits for his Left Upper Trapezius Strain that started in 8/25/2016. TM reports his pain at rest is 1-2/10; tightness, but with movement at work his pain can be up to 7/10. The pain is gradual as the shift progresses. ESI help him with manage his symptoms. For the fast couple of weeks, heat and the light massage of his left upper trapezius has improved his current condition. TM denies cervical neck pain, radiating pain, tingling, numbness, or loss of movement in his upper extremities. TM is not taking naproxen or acetaminophen as ordered.
The Human Papillomavirus, which causes genital warts and cervical cancer, among other things, is spreading worldwide especially in peoples aged 15-25. Because of the demographics of HPV, all incoming high school freshman should be required to get the Gardasil vaccine prior to enrollment. Gardasil is a safe vaccine that protects against the Human Papillomavirus which causes the most common types of cancer. Researchers say that people are most likely to be exposed to HPV in high school, so it’s the perfect time to vaccinate.
This trial had randomly selected 119 patients with neck pain associated with ‘active trigger points’. The patients aged between 30 and 60 years old. The results proved that myofascial release was beneficial especially when combined with heat therapy. (Hou, Tsai, Cheng, Chung & Hong, 2002). The Physiotherapy department, Health Sciences School, University of Granada, Spain (2008) conducted a randomized clinical trial which supported the effectiveness of myofascial release. The effects of this technique when applied after high-intensity exercise, were examined and recorded with 62 randomly selected people. The results concluded that the treatment was beneficial for the recovery of the heart rate variability (HRV) and diastolic blood pressure (BP) (Arroyo-Morales et al., 2008). However, it is difficult to apply these findings to clinical situations because the mean age used for this experiment was 21.1 ± 2.16 years. A larger age group is required to apply to general
Cervical cancer is one of the leading causes of cancer related mortality in countries such as India accounting for more than 17% of all cancer deaths in women aged 30-69. [3] Cervical cancer is one such type of cancer in which screening plays a significant role. Clinical trials done in below poverty level populations do encounter ethical issues to a certain extent with regards to informed consent as most or all of these patients are illiterate. However informed consent is extremely important when justifying data for such clinical trials. Countries such as US have implemented Pap smear screening as one of the most important cervical cancer screening methods. In countries as densely populated as India where proper healthcare facilities does not reach slums and extremely poverty stricken societies, alternatives for screening are indicated- VIA or Visual inspection with acetic acid
The second journal article I found was about TENS at both high and low rate frequencies reducing primary hyperalgesia in rats with joint