Neck Solutions Blog

February 24, 2008

Facet Joint Involvement in Chronic Neck and Low Back Pain

Filed under: Back Pain,Neck Pain — Administrator @ 3:40 pm

Age-Related Prevalence of Facet-Joint Involvement in Chronic Neck and Low Back Pain

From: Pain Physician 2008; 11:67-75

Background: Spinal pain is common in all age groups. While the research has focused primarily on incidence and prevalence in younger working adults, there is evidence that spinal pain is one of the most frequent complaints in older persons and is responsible for functional limitations. While facet arthrosis is a common radiographic finding, which has been suggested to be a potential cause of spinal pain, nearly 10% of all adults show signs of degeneration by the time they reach age 30. Radiographic changes of osteoarthritis have been shown to be equally common in patients with and without low back or neck pain. The studies of low back pain have shown the prevalence of facet joint involvement to be approximately 15% to 45%. However, age related prevalence of facet joint neck pain has not been studied. Objective: To assess age-related prevalence and false-positive rates of facet-joint involvement in chronic spinal pain using controlled comparative local anesthetic blocks.

Design: Retrospective analysis of 424 patients, divided into 6 groups based upon age (Group I: aged 18 – 30 years, Group II: aged 31 – 40 years, Group III: aged 41 – 50 years, Group IV: aged 51 – 60, Group V: 61 – 70 years, and Group VI: greater than 70 years of age).

Results: The prevalence of cervical facet joint-related pain was the lowest (33%) in Group VI and highest (42%) in Group I. False-positive rates for cervical facet joint blocks ranged from 39% (Group III) to 58% (Group V) with an overall false-positive rate of 45%. The prevalence of facet joint involvement in lumbar spinal pain ranged from 18% (in Group II) to 44% (in Group IV), with significant differences noted when Group II and Group III were compared to other groups and with higher rates in Group V.

Conclusion: This study demonstrated a variable age-related prevalence of facet joint pain in chronic low back pain, whereas in the cervical spine it was similar among all the age groups.


February 23, 2008

Stressful tasks in female office workers with neck pain

Filed under: Neck Pain — Administrator @ 5:48 pm

Alterations in cervical muscle activity in functional and stressful tasks in female office workers with neck pain

From: European journal of applied physiology. 2008 Feb 22

This study determined differences between computer workers with varying levels of neck pain in terms of work stressors, employee strain, electromyography amplitude and heart rate response to various tasks. Participants included 85 workers (33, no pain; 38, mild pain; 14, moderate pain) and 22 non-working controls. Work stressors evaluated were job demands, decision authority, and social support. Heart rate was recorded during three tasks: copy-typing, typing with superimposed stress and a colour word task. Measures included electromyography signals from the sternocleidomastoid, anterior scalene, cervical extensor and upper trapezius muscles bilaterally. Results showed no difference between groups in work stressors or employee strain measures. Workers with and without pain had higher measured levels of electromyography amplitude in sternocleidomastoid, anterior scalene and cervical extensor muscles during the tasks than controls. In workers with neck pain, the upper trapezius had difficulty in switching off on completion of tasks compared with controls and workers without pain. There was an increase in heart rate, perceived tension and pain and decrease in accuracy for all groups during the stressful tasks with symptomatic workers producing more typing errors than controls and workers without pain. These findings suggest an altered muscle recruitment pattern in the neck flexor and extensor muscles. Whether this is a consequence or source of the musculoskeletal disorder cannot be determined from this study. It is possible that workers currently without symptoms may be at risk of developing a musculoskeletal disorder.

February 17, 2008

Exercise Helps Chronic Pain

Filed under: General Health — Administrator @ 7:15 pm

The Immediate and Long Term Benefits of Physical Conditioning in Chronic Pain Patients

From: American Academy of Pain Medicine 24th Annual Meeting: Abstract 105.

Introduction: A frequent co-morbid condition of chronic pain is profound physical deconditioning that results from inactivity. Objective assessment of physical conditioning in patients with chronic pain has been impeded by several factors that this study attempted to overcome. Of primary importance is verifying the efficacy of a physical reconditioning program. Further, decreases in pain, depression, and anxiety following treatment in a pain rehabilitation program have been well documented; however, no study has determined the immediate effects of brief exercise on these factors. The purposes of this study are a) to determine the effect of a 3 week aerobic training program on physical conditioning, and b) to assess the acute effects of a brief (10 minute) exercise protocol on pain, mood, and perceived exertion.

Conclusion: This research suggests that relatively modest exercise leads to improved mood and physical capacity, which has further implications for mortality risk. Further, it suggests that brief exercise is a safe, cost-free, nonpharmacologic strategy for immediately reducing depression and anxiety.

February 10, 2008

Icy Hot Recall

Filed under: General Health — Administrator @ 12:29 pm

Chattem, Inc. announced that it is initiating a voluntary Nationwide recall of its Icy Hot Heat Therapy products, including consumer samples that were included on a limited promotional basis in cartons of its 3 oz. Aspercreme product. Chattem is recalling these products because it has received some consumer reports of first, second and third degree burns as well as skin irritation resulting from consumer use or possible misuse of these products.

Chattem Issues URGENT Voluntary Nationwide Recall of Icy Hot Heat Therapy Products (Feb. 8)

February 7, 2008

Whiplash and neck ligament strength

Filed under: Neck Pain,Whiplash — Administrator @ 9:40 am

Neck ligament strength is decreased following whiplash trauma

From: BMC Musculoskeletal Disorders 2006, 7:103

Previous clinical studies have documented successful neck pain relief in whiplash patients using nerve block and radiofrequency ablation of facet joint afferents, including capsular ligament nerves. No previous study has documented injuries to the neck ligaments as determined by altered dynamic mechanical properties due to whiplash. The goal of the present study was to determine the dynamic mechanical properties of whiplash-exposed human cervical spine ligaments. Additionally, the present data were compared to previously reported control data. The ligaments included the anterior and posterior longitudinal, capsular, and interspinous and supraspinous ligaments, middle-third disc, and ligamentum flavum.

A total of 98 bone-ligament-bone specimens (C2–C3 to C7-T1) were prepared from six cervical spines following 3.5, 5, 6.5, and 8 g rear impacts and pre- and post-impact flexibility testing. The specimens were elongated to failure at a peak rate of 725 (SD 95) mm/s. Failure force, elongation, and energy absorbed, as well as stiffness were determined. The mechanical properties were statistically compared among ligaments, and to the control data. The average physiological ligament elongation was determined using a mathematical model.

Results: For all whiplash-exposed ligaments, the average failure elongation exceeded the average physiological elongation. The highest average failure force of 204.6 N was observed in the ligamentum flavum, significantly greater than in middle-third disc and interspinous and supraspinous ligaments. The highest average failure elongation of 4.9 mm was observed in the interspinous and supraspinous ligaments, significantly greater than in the anterior longitudinal ligament, middle-third disc, and ligamentum flavum. The average energy absorbed ranged from 0.04 J by the middle-third disc to 0.44 J by the capsular ligament. The ligamentum flavum was the stiffest ligament, while the interspinous and supraspinous ligaments were most flexible. The whiplash-exposed ligaments had significantly lower failure force, 149.4 vs. 186.0 N, and a trend towards less energy absorption capacity, 308.6 vs. 397.0 J, as compared to the control data.

The present decreases in neck ligament strength due to whiplash provide support for the ligament injury hypothesis of whiplash syndrome.


February 6, 2008

Indoor Allergies

Filed under: General Health — Administrator @ 12:13 pm

Symptoms of indoor allergies

Indoor allergy sufferers will often wheeze, sneeze, cough and hack their way through the winter months, thinking they have a chronic cold. In actuality, they are probably reacting to indoor allergens. Some symptoms between a cold and allergies are similar, such as sneezing and a stuffy or runny nose. But, if your symptoms are also accompanied with a fever, sore throat, colored nasal discharge, and aches and pains, then you probably have a cold. With allergies, there is never a fever, the nasal discharge is clear, and eyes may become red and itchy. Furthermore, while a cold usually lasts about a week, allergies can last all year.

Prevention of common indoor allergens

The key is to focus on sites where allergens accumulate. The term “allergen” refers to any substance that can trigger an allergic response. First, you must know which allergens or irritants in your home provoke your symptoms.


A Three-Year Follow-up of Lumbar Spine Endplate (Modic) Changes

Filed under: Back Pain,Disc Problems — Administrator @ 10:52 am

A Three-Year Follow-up of Lumbar Spine Endplate (Modic) Changes

From: Spine 2006;31(15):1714-1718

A longitudinal follow-up of Modic changes on magnetic resonance imaging (MRI).

Modic changes are bone marrow and endplate lesions visible in magnetic resonance imaging (MRI). They were first described in the 1980s with a prevalence affecting 22% to 50% of discs in patients with degenerative intervertebral disc disease. Modic Type I lesions, hypointense in T1-weighted sequences and hyperintense in T2-weighted sequences, are assumed to indicate an ongoing active degenerative process. Type II lesions, hyperintense both in T1- and T2-weighted sequences, are thought to manifest a more stable and chronic process reflecting fatty degeneration of the bone marrow. Type III lesions, hypointense both in T1- and T2-weighted sequences, are thought to correlate with subchondral bone sclerosis.

Mixed Modic lesions (Type I/II and Type II/III) have also been identified. Braithwaite et al suggested that Modic changes can convert from one type to another and that they all present different stages of the same pathologic process. Modic et al showed that Type I changes commonly progress to Type II changes, but they can also revert back to normal. Furthermore, they observed that Type II changes usually do not alter with time. Apart from the study of Modic et al, no studies on the natural course of Modic changes have been undertaken. The purpose of this prospective study was to assess the prevalence, extent, and natural course of Modic changes over a 3-year follow-up period.


February 5, 2008

Acute low back pain prognosis

Filed under: Back Pain — Administrator @ 6:40 pm

Acute low back pain: systematic review of its prognosis

From: BMJ 2003;327:323

To describe the course of acute low back pain and sciatica and to identify clinically important prognostic factors for these conditions in a systematic review.

Data sources Searches of Medline, Embase, Cinahl, and Science Citation Index and iterative searches of bibliographies.

Main outcome measures Pain, disability, and return to work.

Results 15 studies of variable methodological quality were included. Rapid improvements in pain (mean reduction 58% of initial scores), disability (58%), and return to work (82% of those initially off work) occurred in one month. Further improvement was apparent until about three months. Thereafter levels for pain, disability, and return to work remained almost constant. 73% of patients had at least one recurrence within 12 months.

People with acute low back pain and associated disability usually improve rapidly within weeks. None the less, pain and disability are typically ongoing, and recurrences are common.


Neck Pain and Associated Disorders

Filed under: Neck Pain — Administrator @ 10:56 am

The Bone and Joint Task Force on Neck Pain and Its Associated Disorders

From: SPINE Volume 33, Number 4S, pp S5–S7

The Task Force on Neck Pain and Its Associated Disorders is an initiative of the United Nations and the World Health Organization with the purpose of informing and empowering people with neck pain or who are at risk of developing neck pain. They hope to change attitudes and beliefs about neck pain and its prevention, diagnosis, treatment, and management.

Key Findings From the Task Force

    Epidemiology of Neck Pain

  • Most people can expect to experience some neck pain in their lifetimes, although for the majority, neck pain will not seriously interfere with normal activities.
  • Depending on the case definitions used, the 12 month prevalence of neck pain ranged from 12.1% to 71.5% in the general population, and from 27.1% to 47.8% in workers. However, neck pain with associated disability was less common: 12 month prevalence estimates ranged from 1.7% to 11.5% in the general population.
  • Each year, between 11% and 14.1% of workers reported being limited in their activities because of neck pain. Neck pain was common in all occupational categories, and the results of the Ontario cohort study suggest that workerfs compensation data significantly underestimate the burden of neck pain in workers.
  • The number of persons seeking health care in emergency rooms for traffic-related Whiplash associated disorders (WAD) has been increasing over the past 3 decades.


February 4, 2008

Olivier Parmesan and Asiago Garlic and Basil Dip Warning

Filed under: General Health — Administrator @ 10:39 am

Olivier brand Parmesan and Asiago Dip with Garlic and Basil

Dr. Mark Horton, Director of the California Department of Public Health (CDPH), today warned consumers not to eat Olivier brand Parmesan and Asiago Dip with Garlic and Basil, because of the possibility of contamination with Clostridium botulinum. The product was distributed to William-Sonoma retail stores nationwide and to Olivier Napa Valley retail stores located in Truckee and St. Helena, California.

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