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management of neck pain

Jane Nikles, Subaat Khan, John Leou, Gerben Keijzers, Joanna Ng, Catherine Bond, Gota Nakamura, Rhonda Le, Michele Sterling
OBJECTIVE: To describe clinical presentation and management of neck soft tissue injury in an Australian ED. METHODS: This is a retrospective cohort study conducted in a tertiary hospital ED in Queensland, Australia. This study included all patients aged 18-65 years presenting with neck sprain/strain in 2016. Main outcome measures are patient demographics, comorbidities, presentation, acute management and follow up. RESULTS: Of 339 patients, 176 (52%) had cervical computed tomography (CT) scans and 3% plain radiographs...
March 20, 2019: Emergency Medicine Australasia: EMA
Celeste Tavolaro, Samia Ghaffar, Haitao Zhou, Quynh Nguyen, Carlo Bellabarba, Richard Bransford
BACKGROUND: Ankylosing spinal disorder (ASD) patients are at a greater risk for spinal fractures due to osteoporosis and rigidity of the spinal column. These fractures are associated with a high risk of neurologic compromise resulting from delayed or missed diagnoses. Although CT is usually the initial imaging modality, MRI has been proposed as mandatory to help identify spinal injuries in ASD patients with unexplained neck or back pain or known injuries to help identify non-contiguous fractures...
March 16, 2019: Spine Journal: Official Journal of the North American Spine Society
Anjali Gupta, Greg Summerville, Carlin Senter
PURPOSE OF REVIEW: Here, we summarize the current scientific literature on the management of sports-related concussion (SRC) in the acute period (< 6 weeks post-injury) with a focus on rest, return to learn, return to play, and emerging treatments. RECENT FINDINGS: While relative rest is recommended for the first 24-48 h following acute SRC, the most recent guidelines highlight the lack of evidence for complete rest and in fact show that prolonged cognitive and physical rest can be detrimental...
March 18, 2019: Current Reviews in Musculoskeletal Medicine
Christopher H Rashidifard, Nicholas Romeo, Mark Richardson, Paul Muccino, Thomas DiPasquale, Chelsea M Bush
Introduction: This case-control study evaluates the success of indwelling pain catheters in nonoperatively treated femoral neck fractures (FNFs) for end-of-life pain management. Methods: Patients older than 65 years with nonoperatively treated FNFs were retrospectively identified at a level 1 trauma center between March 2012 and September 2015. Twenty-three received indwelling continuous peripheral pain catheters (experimental) and 10 received traditional pain control modalities (control)...
2019: Geriatric Orthopaedic Surgery & Rehabilitation
Emery R Eaves, Clarissa W Hsu, Lynn L DeBar, Catherine J Livingston, Laura E Ocker, Sarah J McDonald, Laurel Dillon-Sumner, Cheryl Ritenbaugh
OBJECTIVES: The authors employ a Whole Systems framework to explore implementation of new guidelines for back and neck pain in Oregon's Medicaid system. Whole Systems research is useful for understanding the relationship between complementary and integrative health care (CIH) and conventional health care systems in real-world clinical and practice settings. DESIGN: Preliminary results are from an observational study designed to evaluate state-wide implementation of CIH and other non-pharmacological treatments for neck and back pain among Oregon Medicaid patients...
March 2019: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
Mariana Leonel Martins, Aline Dos Santos Letieri, Michele Machado Lenzi, Michelle Agostini, Gloria Fernanda Castro
The aim of this report was to describe an approach for a child with phakomatosis pigmentovascularis Type IIb associated with bilateral Sturge-Weber syndrome and autistic spectrum disorder. A 6-year-old boy was referred to the Special Care Dental Clinic with the main complaints of "damaged teeth and pain." The physical examination revealed bilateral port-wine staining on the face, neck, and upper and lower limbs, congenital dermal melanocytosis on the back, and dilated blood vessels in the sclera. Intraoral examination revealed hypertrophy of the maxillary bone, diffuse and intense redness of the oral mucosa, crowding, anterior open bite, and carious lesions in the left and right upper second primary molars...
March 13, 2019: Special Care in Dentistry
Cristian Valdez, Adriano Valdez
Forestier Disease, or Diffuse Idiopathic Skeletal Hyperostosis (DISH), causes a considerable ossification of the anterior longitudinal ligament of the spine. When it involves cervical segments, it can be accompanied by dysphagia, dysphonia and/or dyspnea. This entity usually has a benign course. Surgical treatment is required for progressive cases. We report a 72-year-old male with a history of chronic cervical pain and slight neck stiffness. On the imaging studies, there was an exuberant ossification of the anterior longitudinal ligament, at the cervical spine level, between C2 and C7...
December 2018: Revista Médica de Chile
Joseph P Drain, Sohrab S Virk, Nikhil Jain, Elizabeth Yu
STUDY DESIGN: This study was a systematic review. OBJECTIVES: To reveal demographic factors, etiologies, response to treatment, and to propose a novel treatment algorithm for dropped head syndrome (DHS). SUMMARY OF BACKGROUND DATA: DHS is a rare condition defined by weakness of the cervical paraspinal muscles resulting in passively correctable flexion of the cervical spine. Patients present with neck pain, difficulty eating, and impaired horizontal gaze...
March 5, 2019: Clinical Spine Surgery
Vishal M Bulsara, Max K Bulsara, Emma Lewis
INTRODUCTION: Osteoradionecrosis (ORN) of the mandible is a painful and debilitating condition occurring after radiotherapy to the head and neck to treat cancer. For decades, hyperbaric oxygen (HBO) has formed the mainstay of the early management of ORN. Literature about the efficacy of HBO is contentious. Recently, Oral and Maxillofacial surgical units in France and UK have trialled a combination of medications to treat ORN, also known as PENTOCLO (PENtoxifylline+TOcopherol±CLOdronate)...
March 4, 2019: BMJ Open
Ivan Lin, Louise Wiles, Rob Waller, Roger Goucke, Yusuf Nagree, Michael Gibberd, Leon Straker, Chris G Maher, Peter P B O'Sullivan
OBJECTIVES: To identify common recommendations for high-quality care for the most common musculoskeletal (MSK) pain sites encountered by clinicians in emergency and primary care (spinal (lumbar, thoracic and cervical), hip/knee (including osteoarthritis [OA] and shoulder) from contemporary, high-quality clinical practice guidelines (CPGs). DESIGN: Systematic review, critical appraisal and narrative synthesis of MSK pain CPG recommendations. ELIGIBILITY CRITERIA: Included MSK pain CPGs were written in English, rated as high quality, published from 2011, focused on adults and described development processes...
March 2, 2019: British Journal of Sports Medicine
Janina Christoforou, Jumana Karasneh, Maddalena Manfredi, Bella Dave, Jennifer S Walker, Pedro Diz Dios, Joel Epstein, Navdeep Kumar, Michael Glick, Peter B Lockhart, Lauren L Patton
OBJECTIVE: To evaluate the current evidence regarding the effectiveness of non-opioid interventions for the therapeutic management of pain in head and neck cancer patients with oral mucositis resulting from radiotherapy only or chemoradiotherapy. MATERIALS AND METHODS: A literature search was conducted which included randomized controlled trials that assessed patient-related outcome of pain in patients with oral mucositis associated with radiation therapy only or chemoradiotherapy...
February 27, 2019: Oral Diseases
Beomjune B Kim, Arshad Kaleem, Shadi Alzahrani, Melvyn Yeoh, Waleed Zaid
BACKGROUND: Pedicle ossification is thought to arise from the residual perieosteum left along the pedicle during the fibula free flap (FFF) harvesting. Pedicle ossification in head and neck reconstruction can cause trismus, pain on mastication/turning the neck, or neck swelling. METHODS: Two patients reported in this article developed severe trismus within 6 months after mandibular reconstruction with FFF. CT scans revealed ossification along the vascular pedicle interfering with mouth opening...
February 27, 2019: Head & Neck
Yavuz Samanci, Ismet Baskurt, Suat Erol Celik
Retroclival epidural hematomas are particularly rare conditions that are frequently the result of high-energy, hyperflexion-hyperextension injuries in pediatric patients. We present the case of a 7-year-old previously healthy girl with traumatic retroclival epidural hematoma after a fall from a swing. She presented with a Glasgow Coma Scale score of 15 with severe neck pain and limitation of cervical movements in all directions. Radiological examination revealed retroclival epidural hematoma, and the patient was managed conservatively with good recovery...
February 19, 2019: Pediatric Emergency Care
Arif Musa, Saif Aldeen Farhan, Yu-Po Lee, Brittany Uribe, P Douglas Kiester
Background: We report a case of an elderly patient who was diagnosed with lateral atlantoaxial subluxation with type II odontoid fracture, an extremely uncommon upper cervical spine injury that has not been previously reported in the literature to the knowledge of the authors. Methods: An 87-year-old male reported to the emergency room following a syncopal episode after sustaining a fall. He complained of dizziness, fatigue, disruption of vision and audition, and worsening neck pain...
January 2019: International Journal of Spine Surgery
Aleena Zia, Sumit Sohal, Chris Costas
Pylephlebitis is a rare complication of intra-abdominal infections and describes thrombosis and infection as two different pathophysiological phenomena in the cause of this disease. The nonspecific presentation of disease makes its diagnosis difficult and thus leads to high mortality. The treatment comprises antibiotics and also includes controversial use of anticoagulation in these patients. Here, we present a patient with past medical history of human immunodeficiency virus and past diverticulitis who presented with fever, chills, diarrhea, neck pain, and photophobia...
2019: Case Reports in Infectious Diseases
Ron B Mitchell, Sanford M Archer, Stacey L Ishman, Richard M Rosenfeld, Sarah Coles, Sandra A Finestone, Norman R Friedman, Terri Giordano, Douglas M Hildrew, Tae W Kim, Robin M Lloyd, Sanjay R Parikh, Stanford T Shulman, David L Walner, Sandra A Walsh, Lorraine C Nnacheta
OBJECTIVE: This update of a 2011 guideline developed by the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations on the pre-, intra-, and postoperative care and management of children 1 to 18 years of age under consideration for tonsillectomy. Tonsillectomy is defined as a surgical procedure performed with or without adenoidectomy that completely removes the tonsil, including its capsule, by dissecting the peritonsillar space between the tonsil capsule and the muscular wall...
February 2019: Otolaryngology—Head and Neck Surgery
Oleksandr A Iaroshevskyi, Olga G Morozova, Anna V Logvinenko, Yana V Lypynska
OBJECTIVE: Introduction: Today, chronic pain remains a pressing medical and socio-economic problem, despite the rapid development of medical technologies, the presence of a vast arsenal of drug and non-drug treatments. Estimates for chronic pain prevalence ranged from 8% to 60%. At the same time, about 40% of patients report insufficient effectiveness in the treatment of chronic pain syndrome. The aim of the study was to compare the effectiveness of MTrPS management by biomechanical correction of the musculoskeletal system combined with therapeutic exercises, DN and TrPs-pressure release with the effectiveness of MTrPS management by therapeutic exercises combined with DN and TrPs-pressure release in patients with chronic neck-shoulder myofascial pain and FHP...
2019: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Joanne DiFrancisco-Donoghue, Jerry Balentine, Gordon Schmidt, Hallie Zwibel
Objectives: eSport is a form of electronic gaming, also known as professional or competitive video gaming, and is growing at a rapid pace worldwide. Over 50 US colleges have established varsity gaming teams over the past three years; some colleges offer eSport scholarships as they do for traditional sports. There is little objective research on the health habits of these players who are often placed under the direction of the athletics department on college campuses, and there is currently no health management model on how to treat these new athletes...
2019: BMJ Open Sport & Exercise Medicine
Narihito Nagoshi, Osahiko Tsuji, Eijiro Okada, Nobuyuki Fujita, Mitsuru Yagi, Takashi Tsuji, Masaya Nakamura, Morio Matsumoto, Kota Watanabe
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: The old-version JOA score for cervical myelopathy (CM) is an evaluation system performed by medical providers that focuses only on neurological function. The purpose of this study was to evaluate patient-reported outcomes using the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), and to clarify clinical factors that affect the therapeutic effectiveness for CM. SETTING: Single institute in Japan...
February 21, 2019: Spinal Cord
Kalaiarasi Raja, Sithananda-Kumar Venkatesan, Sivaraman Ganesan, Arun Alexander
Introduction:  Penetration injury to the neck constitutes 5-10% of all trauma cases. Penetration of a foreign body into the trachea with subsequent impaction into the tracheoesophageal party wall is extremely rare. We present a patient with an unusual penetrating injury of the neck caused by a metallic foreign body embedded into the tracheoesophageal party wall, and its management. Case Report: A 35-year-old male presented to the emergency department with a history of accidental penetrating injury on his neck, with severe pain and bleeding from the wound entry site...
January 2019: Iranian Journal of Otorhinolaryngology
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