Head and Neck diseases

Whiplash injury

Whiplash is currently defined as a non-specific diagnosis of soft tissue  caused by hyperflexion, hyperextension, or rotation injury and resulting from car accidents and other types of traumatic forces which often cause strain to the muscles and sprain trauma to cartilage, tendons and ligaments in the neck, often associated with headaches and stiffness or painful neck muscle tension.  Motor vehicle crashes (MVCs) are the most common mechanism of injury[7]. Management of acute whiplash injury traditionally includes rest and analgesia, often in conjunction with a brief period of neck immobilization in a soft cervical collar. Most patients with whiplash injuries have persistent pain for at least 6 weeks.

Symptoms may start immediately or be delayed. Patients with neck pain after a whiplash injury from a rear impact traffic accident commonly present to a trauma center. After an osseous or neurological injury to the cervical vertebral column is excluded, the non-specific diagnosis of soft tissue sprain/strain or “whiplash” is made. In clinical practice, the patient is often discharged with a soft cervical collar and analgesia for pain relief [8].

cervical collars should not be universally recommended to all whiplash patients. However, for patients who find it useful for symptom relief, Paksaman soft cervical collar for about 2 week has shown an impact on pain relief[2].

 

Chronic neck pain

no specific cause can be identified for chronic neck pain[9]. Neck pain is one of the most prevalent and costly health problems. It remains a complex, subjective experience with a variety of musculoskeletal causes. Although the etiology of neck pain is usually known, it is often difficult to predict which patients will respond to conservative care and which patients will have persistent pain, despite several interventions. Most musculoskeletal conditions resulting in neck pain respond quickly to conservative treatment such as soft collar. Cervical collar can support neck and decrease cervical muscle spasm and also protect sensitive areas after a sprain or strain

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Radicular neck pain

Cervical radiculopathy is a pathologic process involving the nerve root, arising from disc herniation, spondylosis, tumor, or trauma causing nerve root avulsion. Cervical radiculopathy may also occur in a setting in which no definite cause can be determined. The typical clinical picture is pain, paresthesia, weakness, or a combination of these symptoms. In most studies, the pain is present in the upper limb more frequently than in the neck, although it is usually present in both the areas. Cervical radiculopathy can usually be treated without surgery in some patients [10, 11]. Sometimes, soft collar is used for acute pain and decreasing symptoms.

Cervical Disc prolapsed

Herniated disc are most common in early to middle-aged adults and are often caused when too much pressure is put on an otherwise healthy spine, Bad posture and poor ergonomics may also contribute to its likelihood. The most common cause of a cervical herniated nucleus pulposus is gradual degeneration of the disc, attenuation (weakening) of the posterior annulus fibrosis, and subsequent protrusion of the nucleus pulposus into the spinal canal causing compression of the nerve root. Sometimes the disc injury occurs suddenly because of an accident or trauma. Most often, however, a cervical disc herniation occurs over time, and patients finally take notice when the neck pain symptoms and/or radiculopathy (radiating arm pain, numbness, and/or weakness) become significant. Although there is an extensive list of risk factors for the development of neck pain (and disc problems), a disc injury can occur in almost any person. A cervical disc injury occurs most frequently in people over the age of 40 years old, and affects men and women equally

Patients with a slipped disc in the neck will experience severe pain, which can be present in the neck, shoulder and down the arm. This pain can be exacerbated by neck movements and even by coughing or sneezing. The pain can be so severe it may stop the person from sleeping. Muscle spasm in the neck is common

When the symptoms appear, the patient should rest and take pain-relieving medication. Anti inflammatory medication prescribed by a doctor is usually very effective. Paksaman Neck Collar (soft collar and hard collar which supports the neck and prevents movement) can be very helpful in the early stages of this injury. It removes stresses on the neck and restricts any painful movements. 

Cervical Spondylosis (Arthritis of the Neck)

Cervical spondylosis, also known as cervical osteoarthritis or neck arthritis, is a common, age-related condition that affects the joints and discs in your neck. Osteoarthritis neck pain symptoms are due to wear and tear that thins out the cushioning discs, or cartilage, between the bones, or vertebra, in your neck. Over time, cervical spondylosis develops, leading to bone spurs in brims that interfere with neck mobility. While it’s largely due to age, it can be caused by other factors as well.

In most people, cervical spondylosis causes no symptoms. When symptoms do occur, they typically include pain and stiffness in the neck. This pain can range from mild to severe. It is sometimes worsened by looking up or looking down for a long time, or by activities in which the neck is held in the same position for a prolonged period of time—such as driving or reading a book. The pain usually improves with rest or lying down and also your doctor may advise you to wear a soft cervical collar to limit neck motion and allow the muscles in your neck to rest.

Rheumatoid arthritis (RA)

RA may affect the cervical spine, resulting in pain and stiffness in the neck that affects the ability of the patient to turn the head and bend the neck. Damage to the cervical spine occurs from joint inflammation. Chronic inflammation may lead to loss of cartilage and bone and loosening of ligaments (the fibrous cords that connect bone to bone and cartilage to cartilage). Formation of pannus (a build-up of tissue composed of immune cells) in affected joints may lead to a narrowing of the joint area and result in compression of the spinal cord, causing a range of nerve symptoms, including pain and sensory loss in the hands and feet. Initial approach to management of RA-related symptoms affecting the cervical spine should include medications to control inflammation and pain. Other interventions that may be useful in controlling pain include use of a neck brace or  hard collar[12]

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