stiff neck
DESCRIPTION
Stiff neck. Outcomes. Be familiar with the clinical presentation of an acute cervical locking and a discogenic locked neck. Be familiar with the most widely used physiotherapy treatment protocol for a patient with a typical acute cervical locking and a discogenic locked neck. Types. - PowerPoint PPT PresentationTRANSCRIPT
STIFF NECK
Outcomes Be familiar with the clinical presentation
of an acute cervical locking and a discogenic locked neck.
Be familiar with the most widely used physiotherapy treatment protocol for a patient with a typical acute cervical locking and a discogenic locked neck.
Types Postural
Atlanto-axial rotation fixation
Spasmodic torticollis
Hysterical torticollis
Stiff neck as a result of muscles
History Painless contracture of one of the
sternocleidomastoïd muscles
Gives rise to the neck fixating in side flexion towards the affected side and rotation away from it
Lack of treatment may lead to permanent deformity
Acute cervical locking Sudden onset A snapping sound is heard Sudden uncontrolled movement Most common between C2/C3 Synovial pinching Localised to the mid-cervical area Severe, sharp pain with proximal referral
the patient should try to move out of the position
Acute cervical locking (cont)
Noticeable lateral flexion, slight flexion/rotation away from the pain
During PAIVMS’s any movements which decreases the articular space would evoke the familiar pain
Treatment Try to unlock the joint as soon as possible Longitudinal in position of deformity Rotation and lateral flexion Grade IV- Joint MUST be unlocked on day 1 Further treatment must be directed
towards pain relief, muscle spasm and gaining full joint mobility
Traumatic onset History of trauma eg. bump against head
If not unlocked on day 1: Manipulation
Strengthening Muscle
spasm
Discogenic locked neck Gradual onset No specific movement May awake with locked neck Any level between C2-C7 Disc Neck pain Worst pain is over medial scapula area
(Cloward area’s) Deep pain
Dicskogenic locked neck (cont)
Noticeable flexion, lateral flexion away from the pain
Extension, lateral flexion and rotation towards the painful side is stiff but not blocked
Treatment Intermittent constant cervical traction
Transverse movement
Unilateral PA
Rotation and lateral flexion
Longitudinal cephalad Grade I, II and IV-
Treatment (cont)
With distal symptoms the treatment must be of a longer duration
Slower recovery if other structure eg. dura and nerve roots also show symptoms
Restriction of extension is often one of the remaining signs after treatment
Central PA Grade IV often clears this sign