Advances in the diagnosis and management of neck pain

Abstract

Neck pain imposes a considerable personal and socioeconomic burden-it is one of the top five chronic pain conditions in terms of prevalence and years lost to disability-yet it receives a fraction of the research funding given to low back pain. Although most acute episodes resolve spontaneously, more than a third of affected people still have low grade symptoms or recurrences more than one year later, with genetics and psychosocial factors being risk factors for persistence. Nearly half of people with chronic neck pain have mixed neuropathic-nociceptive symptoms or predominantly neuropathic symptoms. Few clinical trials are dedicated solely to neck pain. Muscle relaxants and non-steroidal anti-inflammatory drugs are effective for acute neck pain, and clinical practice is mostly guided by the results of studies performed for other chronic pain conditions. Among complementary and alternative treatments, the strongest evidence is for exercise, with weaker evidence supporting massage, acupuncture, yoga, and spinal manipulation in different contexts. For cervical radiculopathy and facet arthropathy, weak evidence supports epidural steroid injections and radiofrequency denervation, respectively. Surgery is more effective than conservative treatment in the short term but not in the long term for most of these patients, and clinical observation is a reasonable strategy before surgery.

Neck pain: a clinical analysis of causes and therapy priorities

“…Электромиография и электронейромиография -ключевые методы, которые используются для выявления особенностей корешкового поражения и имеют две основные цели: 1) подтверждение наличия дисфункции спинномозгового корешка и исключение других заболеваний периферических нервов, таких как плексопатия; 2) определение уровня и характера корешкового поражения (демиелинизация, аксонопатия, блок проводимости). Чувствительность электронейромиографии при шейной радикулопатии составляет от 50 до 71% [10].…”

“…Вопрос о целесообразности использования дополнительных методов исследования решается в зависимости от наличия соответствующих показаний и основывается, прежде всего, на концепции «красных флажков» (признаков потенциально описных причин цервикальной боли; табл. 2) [10].…”

Orientation of the Head and Trunk During Functional Upper Limb Movement

“…Neck and shoulder pain is a highly prevalent complaint, with up to 50% of the population being affected at some stage in their life [1,2]. Those participating in sporting activities involving repetitive overhead activity such as baseball, tennis and volleyball are particularly vulnerable to these kinds of musculoskeletal injuries [3][4][5][6][7].…”

“…Those participating in sporting activities involving repetitive overhead activity such as baseball, tennis and volleyball are particularly vulnerable to these kinds of musculoskeletal injuries [3][4][5][6][7]. Invariably, the pathophysiology of neck and shoulder 2 of 14 pain is multifactorial and complex [1,2]. While episodes of acute pain may resolve spontaneously, a large proportion of people experience recurrent injuries or chronic discomfort [8].…”

Coblation annuloplasty in cervical discogenic pain without radiculopathy.

“…The prevalence of neck pain was around 15% in individuals who reported grade II-IV pain intensity [5]; pain is the fourth leading cause of disability, with an annual prevalence exceeding 30% [6]. Most of these cervical pain-afflicted patients received only conservative therapies, and the rest were given limited interventional treatments [7,8]; however, the therapeutic efficacy of these interventions showed huge variance [9], from which some researchers created a multimod-al program for achieving effective pain relief [10]. It is of practical importance to determine an effective method with consistent therapeutic efficacy at controlling cervical discogenic pain (CDP).…”