Neck injury
In medicine, neck injuries are "general or unspecified injuries to the neck. It includes injuries to the skin, muscles, and other soft tissues of the neck.'[1]
Diagnosis
X-ray of the cervical spine should be considered, especially if the patient fulfills any criteria from the Canadian C-Spine Rule clinical prediction rule: [2][3]
- Age 65 years or more
- Paresthesias in extremities
- Dangerous fall ("elevation >=3 ft or 5 stairs; an axial load to the head (e.g., diving); a motor vehicle collision at high speed (>100 km/hr) or with rollover or ejection; a collision involving a motorized recreational vehicle; or a bicycle collision")
- Inability to rotate the neck 45° to the right and left
- Only test if "simple rear-end motor vehicle collision, sitting position in ED, ambulatory at any time since injury, delayed onset of neck pain, or absence of midline C-spine tenderness"[4]
- Glasgow Coma Scale less than 15 (the Canadian C-Spine Rule was only designed for alert patients)
Treatment
It is not clear that ibuprofen 800 mg or cyclobenzaprine 5 mg three times a day is beneficial.[5]
In patients with recent onset of cervical radiculopathy, semi-hard collar and physiotherapy with exercise may reduce pain.[6]
The role of electrotherapy such as pulsed electromagnetic field therapy (PEMF), repetitive magnetic stimulation (rMS) and transcutaneous electrical nerve stimulation (TENS) is not clear.[7]
Low-level laser therapy may help.[8]
Prognosis
Many patients with acute idiopathic neck pain have persistent symptoms.[9] Most reduction in pain and disability occur within 76 weeks without much improvement after 6 weeks (at least among the types of patients studied).[9]
References
- ↑ Anonymous (2024), Neck injury (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Stiell IG, Clement CM, McKnight RD, et al (December 2003). "The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma". N. Engl. J. Med. 349 (26): 2510–8. DOI:10.1056/NEJMoa031375. PMID 14695411. Research Blogging.
- ↑ Stiell, Ian G; Catherine M Clement, Jeremy Grimshaw, Robert J Brison, Brian H Rowe, Michael J Schull, Jacques S Lee, Jamie Brehaut, R Douglas McKnight, Mary A Eisenhauer, Jonathan Dreyer, Eric Letovsky, Tim Rutledge, Iain MacPhail, Scott Ross, Amit Shah, Jeffrey J Perry, Brian R Holroyd, Urbain Ip, Howard Lesiuk, George A Wells (2009-10-29). "Implementation of the Canadian C-Spine Rule: prospective 12 centre cluster randomised trial". BMJ 339 (oct29_4): b4146. DOI:10.1136/bmj.b4146. Retrieved on 2009-11-05. Research Blogging.
- ↑ Stiell IG, Wells GA, Vandemheen KL, et al (October 2001). "The Canadian C-spine rule for radiography in alert and stable trauma patients". JAMA 286 (15): 1841–8. PMID 11597285. [e]
- ↑ Khwaja SM, Minnerop M, Singer AJ (2010). "Comparison of ibuprofen, cyclobenzaprine or both in patients with acute cervical strain: a randomized controlled trial.". CJEM 12 (1): 39-44. PMID 20078917.
- ↑ Kuijper B, Tans JT, Beelen A, Nollet F, de Visser M (2009). "Cervical collar or physiotherapy versus wait and see policy for recent onset cervical radiculopathy: randomised trial.". BMJ 339: b3883. DOI:10.1136/bmj.b3883. PMID 19812130. Research Blogging.
- ↑ Kroeling P, Gross A, Goldsmith CH, Burnie SJ, Haines T, Graham N et al. (2009). "Electrotherapy for neck pain.". Cochrane Database Syst Rev (4): CD004251. DOI:10.1002/14651858.CD004251.pub4. PMID 19821322. Research Blogging.
- ↑ Chow RT, Johnson MI, Lopes-Martins RA, Bjordal JM (2009). "Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials.". Lancet 374 (9705): 1897-908. DOI:10.1016/S0140-6736(09)61522-1. PMID 19913903. Research Blogging.
- ↑ 9.0 9.1 Hush JM, Lin CC, Michaleff ZA, Verhagen A, Refshauge KM (2011). "Prognosis of acute idiopathic neck pain is poor: a systematic review and meta-analysis.". Arch Phys Med Rehabil 92 (5): 824-9. DOI:10.1016/j.apmr.2010.12.025. PMID 21458776. Research Blogging.