Using an exercise ball to help improve muscle strength provides relief from ankylosing spondylitis according to a recent study. The results of this trial offer hope of effective conservative therapy for those with back and neck pain from the condition and may help reduce reliance on pain medications as well as delay the need for neck surgery. Read more
If you’re like many people, receiving a cervical herniated disc diagnosis gives rise to mixed emotions. On the one hand, it is likely a relief to finally know the cause of the neck pain and other forms of discomfort that you may have been struggling with for weeks or months. On the other hand, it can be scary to find out that you are suffering from a degenerative condition that has the potential to get worse over time.
The important thing to keep in mind when you do receive your diagnosis is to remain positive and patient. The treatment process many involve a certain degree of trial and error. It is unlikely that any one treatment will provide total relief, but a combination of conservative treatments like exercise, stretching, medication, and hot/cold compresses will probably help to alleviate your neck pain and other symptoms. Read more
Unlike lumbar and thoracic curves, cervicothoracic junction (CTJ) kyphosis, a distinctive and complex cause of neck pain and other symptoms, is not normally associated with scoliosis. Instead, CTJ deformity involves a sagittal imbalance, where the spine takes on abnormal curvature front to back rather than side to side.
Treating CTJ deformity can be difficult and likely involves back and neck surgery to reconstruct the spine in order to restore balance and realign the neck and head. Read more
Identifying herniated disc symptoms can be difficult, as they can be quite similar to the symptoms associated with other spine conditions. Your primary care physician or a spine specialist are the only ones qualified to properly diagnose a herniated disc, but just because you’re experiencing lower back pain doesn’t mean he or she will automatically assume that you have a herniated disc. Physical exams and tests come first. Read more
A bone spur in the cervical (neck) region of the spine does not often cause recognizable symptoms. In fact, many people develop these excess growths of bone and never even realize they exist. Others might experience nothing more serious than a popping or cracking sound, known as crepitus, that arises when they turn their head left or right. Still others might begin to feel mild stiffness, especially after sleeping or after hours of sitting hunched over a computer keyboard or standing at a work station. Then, there are more severe symptoms related to a spinal bone spur. These can become debilitating, or at the very least cause a person to scale down their level of physical activity. Read more
Bulging disc surgery is a perfectly legitimate option for alleviating the debilitating symptoms often associated with spinal nerve compression if – and this is a big “if” – the symptoms remain stubbornly unaffected by the potential benefits of a well-planned regimen of conservative, nonsurgical treatment. The fact is, more than 90 percent of patients who experience nerve compression related to a bulging disc need never consider surgery. And of the small minority who do consider it, many find through a second or third medical opinion that another, nonsurgical option had been overlooked or ignored. Who, then, should actually consent to surgical treatment for a bulging disc?
Cervical bone spur treatment is a means to alleviate or manage symptoms associated with the growth of excess bone along the sides or edges of the vertebrae located within the neck region of the spine. Far more often than not, someone with bone spurs (osteophytes) within the spine never even realizes they are there. That’s because most bone spurs cause nothing more serious than a popping or cracking noise called crepitus, which can be heard occasionally when the head is turned.
Debilitating, chronic symptoms associated with spinal bone spurs can include pain, tingling, numbness, or muscle weakness in the upper extremities. These symptoms are caused by spinal nerve compression.
Two newly published studies have found that minimally invasive surgery for neurogenic thoracic outlet syndrome (NTOS) can significantly improve patients’ symptoms. This relatively uncommon condition causes neck pain, paraesthesia in the arms, neck and hands, numbness and weakness in the upper body and is more frequent in young, active and generally healthy patients.
One of the studies found that a fairly recently developed type of surgery is particularly helpful at relieving thoracic outlet syndrome in adolescents when the pinched nerves are being caused by the pectoralis minor tendon. Read more
Researchers in the UK have concluded that active management consultations of whiplash in the emergency department are not cost effective and do not improve patients’ prognosis in acute whiplash, which can cause a number of symptoms, including neck pain. The types of things included in active management for acute whiplash were intensive physiotherapy, promotion of positivity for recovery, exercise, early re-engagement in daily routines, an educational booklet on whiplash, and pain management assistance. Patients receiving this type of care, compared to standard care, saw little additional benefit and no long-term benefits leading the authors to conclude that ‘less is more’ when it comes to acute whiplash care.
Usual Care vs. Active Whiplash Management
The study was published in the Lancet’s February 16th edition and was carried out by Sarah E. Lamb, DPhil, and colleagues from the Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom. A two-step process was rolled out for patients visiting one of 12 hospitals or 15 emergency departments (EDs) taking part in the study. Six of the hospitals and seven of the EDs recruited patients for the active management protocol and the remainder proceeded with usual consultation practices. The data was adjusted for initial whiplash grade and other potential confounding factors.
Symptoms of Whiplash Associated Disorder
Whiplash can cause a number of ongoing problems years after the initial injury and many of these are difficult to connect to the neck trauma, leading to problems in applying proper treatment. There is some evidence that cervical spine instability is more common in those suffering whiplash, with conditions such as facet joint arthritis and tinnitus an increased risk for such patients. Whiplash associated disorder may also involve cognitive deficits that can take weeks, months or even years to resolve, if at all. Headaches and neck pain are commonly associated with whiplash associated disorder and patients are often advised to do their best to avoid unnecessary stress and strain on the neck.
Little Difference with Added Care
Some 3851 patients took part in the first stage of the study, 2253 of whom were seen in hospitals in the active management group and 1598 in the hospitals providing usual care. Just over half of the acute whiplash patients were women (55%) and the mean average age was 37 years. Follow-up data was available for 70% of patients at the 12 month mark and the results showed little difference between the groups. The median Neck Disability Index scores varied by 0.5; a difference of 3 points is considered clinically meaningful.
Is Additional Physiotherapy Helpful in Whiplash?
In step two of the study, half of the patients were given a single physiotherapy session, to consolidate the advice given in their earlier ED visit, and the other half had a series of six physiotherapy sessions. Two thirds (67%) of the patients in the active group completed the prescribed course of physio after whiplash and 80% of the usual care group finished the course; those who provided follow-up data at four months (80%) showed modest benefit for neck disability but there was no long-lasting benefit at eight or twelve months. The additional cost of these sessions and the lack of clear benefit led the researchers to conclude that a single session and usual care in the hospital or emergency department is the recommended treatment for acute whiplash.
Lamb, S.E., et al, Lancet. 2013;381:514-515, 546-556.
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