Neck and Upper Back Pain



Neck and Upper Back Pain





Computer screen time and the use of handheld phones has made upper back and neck pain a common finding. Acute pain can be related to a new activity (such as a new computer work station) or from a trauma such as a motor vehicle induced whiplash. Chronic neck strain can lead to secondary problems including headaches and decreased chest expansion which may influence asthma or mimic angina. Treating these regions is easy and effective.


History



  • Work


  • Activity


  • Recent trauma (such as motor vehicle accident)







Special Tests


Cervical Compression

Pain with compression may imply conditions such as herniated nucleus pulposus, facet arthropathy, and degenerative joint disease/osteoarthritis.



  • Have patient in neutral. Place your interlocked fingers over the head.


  • Use your body weight to gently push down, asking the patient if this action reproduces their symptoms, implying referred pain to the affected upper trapezius and arm.










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Spurling Test



  • With the patient sitting, rotate the head toward the affected side and mildly side bend it toward the same side, then provide downward compression.


  • If this maneuver reproduces symptoms, nerve impingement is likely.










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Cervical Distraction


Sitting



  • Place your hands on each side of the neck with your index fingers under the mandible and lift up.


  • A decrease in symptoms implies nerve impingement from HNP.










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Supine



  • Place your hands under the occiput and on the forehead and pull caudally.


  • A decrease in symptoms implies nerve impingement from HNP.










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Oct 19, 2020 | Posted by in MEDICAL ASSISSTANT | Comments Off on Neck and Upper Back Pain
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