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Showing posts from April, 2013

Neck blog series part 5: Brachial Plexus Pathology:

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What is the Brachial Plexus? Brachial Plexus:  C5 – T1 7 cervical vertebrae 8 cervical nerves: 1st 7:  exit above the corresponding vertebrae C8:  exits below the 7th cervical vertebrae What is Brachial Plexus Pathology? Brachial Plexus Neuropraxia, which is commonly called a “Burner” or “Stinger” Definition:  “Transient brachial plexopathy involving the upper trunk” “Temporary episode of unilateral upper extremity burning dysethesia with or without motor weakness” “Stinger” Tingling that occurs in upper extremity after injury. How much of a problem is Brachial Plexus Pathology: Epidemiology:  (specific studies) 50% of a Division 1 American football teams had 1 or more burners per season. 65% of Division 3 players (201) experienced more than 1 burner during their careers.  70% reported additional burners that they did NOT report. Increased occurrence with defensive players due to more tackling. What are the common symptoms of Br

Neck blog series part 4: Whiplash Associated Disorder:

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What is Whiplash? “acceleration-deceleration mechanism of energy transfer to the neck” “from motor vehicle collisions, but can also occur during other mishaps” “result in bony or soft-tissue injuries (whiplash-injury), which may in turn lead to a variety of clinical manifestations called Whiplash-Associated Disorders (WAD)” (Spitzer, 1995) Whiplash is graded as follows: Grade 0: no neck complaints or signs Grade 1: Pain, stiffness or tenderness, no physical signs Grade 2: Pain, stiffness or tenderness, musculoskeletal signs Grade 3: neurological signs with or without musculoskeletal signs Grade 4: fracture or dislocation Late whiplash: symptoms for more than 6 months What are the common symptoms of Whiplash? This depends on what structures are injured. Here is a list of the common injuries caused by whiplash: Facet joints: Haemarthroses, capsular tears/rupture, articular cartilage damage, joint fractures. Often involved in persistent

Neck blog series: part 3: Cervical facet syndrome

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What is Cervical Facet Joint syndrome? Ghormley (1933) first coined the term facet syndrome to describe symptoms associated with degenerative changes of the lumbar spine. Relatively recently, the term cervical facet syndrome has appeared implying spinal pain presumably secondary to involvement of the posterior articular pilars of the cervical spine. A severe acute episode of Facet joint pain may be due to sudden trauma or more often, Facet pain/Facet Syndrome is chronic in nature – with underlying long term changes in the Facet joint that are often associated with degenerative disc disease. It is not synonymous with Cervical Spondylosis. It can occur with other structural sources of pain simultaneously. How much of a problem is Facet joint syndrome? Facet joints have been implicated as a cause of chronic spinal pain in 54-67% of patients with chronic neck pain. These figures were based on responses to controlled diagnostic facet joint blocks performed in ac

Neck blog series part 2: Cervical Radiculopathy

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What is Cervical Radiculopathy? A product of pathology affecting the cervical nerve root or its dorsal horn ganglion (McKenzie & May, 2006). Causing one or more nerves not to work properly through some sort of compression (trapped nerve), often causing arm pain and even pins and needles, numbness and weakness. How much of a problem is Cervical Radiculopathy? Cervical Radiculopathy (trapped nerve causing arm symptoms) occurs in 3.3 people in every 1000 per year. It affects men and women equally and C6/7 and C5/6 are 90% of all cases. It is most common between the age of 30 and 50 years of age (Constantoyannis et al, 2002). What are the common symptoms of Cervical Radiculopathy? May present as pain, motor dysfunction, sensory deficits or a change in tendon reflexes (Williams & Hoving, 2004). Quality of radicular pain is normally severe/lancinating/shooting whereas non radicular pain (somatic referred pain) is often a vague/dull ache. However ne