Neck Solutions Blog

June 30, 2011

A review of tinnitus symptoms beyond ‘ringing in the ears’: a call to action

Filed under: General Health,Tinnitus — Administrator @ 3:29 am

A review of tinnitus symptoms beyond ‘ringing in the ears’: a call to action

From: Curr Med Res Opin. 2011 Jun 23. [Epub ahead of print]

About 10% of the population experiences tinnitus, a common and distressing symptom characterized by the perception of sound in the absence of external stimuli. There is, however, marked heterogeneity in etiology, perception, and extent of distress among those who experience tinnitus. Reactions to tinnitus vary from simple awareness to severe irritation; some people have difficulty in hearing because of the loudness of the noise. Severe tinnitus causes many, often psychological, symptoms (e.g., tension, frustration, impaired concentration, disrupted sleep). For some, tinnitus is temporary, for others it is longstanding. Although many people adjust successfully, others are disabled by tinnitus; approximately 5% experience persistent and severe symptoms affecting their lifestyle and significantly reducing their quality of life. Because tinnitus is poorly understood and no single therapeutic approach is effective for all patients, many patients are told that ”nothing can be done” and they must ”learn to live with it.”

Tinnitus, often referred to as ‘ringing in the ears’, is highly prevalent. However, patients may also present with a number of other symptoms.

To review the broad range of symptoms of tinnitus, to evaluate their impact on patient quality of life and to explore methods of diagnosis and assessment. An electronic literature search was performed in PubMed between September and December 2010.

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June 28, 2011

Effects of passive correction of scapular position on pain, proprioception, and range of motion in neck-pain patients with bilateral scapular downward-rotation syndrome

Filed under: Neck Pain,Posture — Administrator @ 3:49 am

Effects of passive correction of scapular position on pain, proprioception, and range of motion in neck-pain patients with bilateral scapular downward-rotation syndrome

From: Man Ther. 2011 Jun 24. [Epub ahead of print]

Normal scapular alignment is required for optimal scapulohumeral motions. Scapular alignment is an indicator of possible changes in muscle length and joint position. Bunch and Siegel described a standard for scapular alignment, which specifies that the vertebral border of the scapula is parallel to the spine and is positioned approximately 3 inches from the midline of the thorax. The scapula is situated on the thorax between the second and seventh thoracic vertebrae; it lies flat against the thorax and rotates 30° anterior to the frontal plane.

Previous investigators have described how changes in alignment or movement in shoulder regions has the potential to alter the biomechanics of the cervical spine and produce neck pain. Impairments in scapular alignment are believed to be correlated with specific movement related diagnoses and they provide clues on the cervicoscapular muscle length. Impaired alignment of the scapula may be classified as scapular downward rotation, depressed, elevated, adducted, abducted, tilted, or winged. Scapular downward rotation is defined as a downwardly rotated scapula with the inferior border being more medial than the superior border; the shoulder is lower and slopes downward at the acromial end. Scapular downward rotation can contribute to prolonged compressive loading of the neck as a result of the transfer of the weight of the upper extremities to the cervical region through the attachments of the cervicoscapular muscles (upper trapezius and levator scapulae). Increased upper trapezius muscle length in scapular downward rotation does not effectively transfer the weight of an upper extremity load to the sternoclavicular joint, and increased levator scapulae muscle stiffness may contribute increased compressive load and shear force on the cervical spine during active neck movement. Repetitive and excessive stress in the neck structures has the potential to cause cumulative microtrauma to tissue in the cervical region, neck pain, and limited neck rotation range of motion. Together with pain, a common feature of neck disorders is reduced range of motion of the neck.

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June 26, 2011

The temporal development of Fatty infiltrates in the neck muscles following whiplash injury: an association with pain and posttraumatic stress

Filed under: Chronic Pain,Neck Pain,Whiplash — Administrator @ 3:18 am

The temporal development of Fatty infiltrates in the neck muscles following whiplash injury: an association with pain and posttraumatic stress

From: PLoS One. 2011;6(6):e21194. Epub 2011 Jun 16

Whiplash associated disorders are a well-documented health outcome following a motor vehicle crash. Nearly 50% report persistent symptoms up to two years post injury. Resultant costs for medical and rehabilitative care in the western-world are high. Despite such a large socio-economic problem, reasons for the high rate of transition to chronic pain remain elusive.

Factors associated with poor recovery are not conclusive and rather limited to self-report measures. These include initial higher levels of pain, recognised as the most consistent predictor of poor outcome, with measures of sensory hyperalgesia and posttraumatic stress also showing some prognostic capacity. By virtue of their self-report nature, these factors are open to bias, but no verifiable structural changes (e.g. radiological findings) have shown to be associated with the transition to chronicity. This has contributed to the scepticism surrounding the whiplash condition.

However, recent data has demonstrated structural muscle changes in patients with chronic whiplash associated disorders. Muscle fatty infiltrates on magnetic resonance imaging (MRI) were found in the neck extensor muscles of participants with chronic whiplash associated disorder. These findings were not present in those with chronic non-traumatic neck pain or in healthy controls; suggesting traumatic factors play a role in their development. It is possible the presence of widespread muscle fatty infiltrates is in some way associated with the development of chronic pain following whiplash injury. As the muscle changes have been only established in chronic whiplash associated disorders, it is necessary to now determine how soon following injury they occur and whether they uniquely manifest in those who transition.

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June 23, 2011

The Effect of a Corporate Chair Massage Program on Musculoskeletal Discomfort and Joint Range of Motion in Office Workers

Filed under: Back Pain,Neck Pain — Administrator @ 10:06 am

The Effect of a Corporate Chair Massage Program on Musculoskeletal Discomfort and Joint Range of Motion in Office Workers.

From: J Altern Complement Med. 2011 Jun 20. [Epub ahead of print]

Musculoskeletal disorders are a major cause of health related absences from work in industrialized countries, with the most common of these being back, neck and upper extremity injuries. Musculoskeletal disorders are more prevalent and severe among women. Work related musculoskeletal disorders are those induced or aggravated by work responsibilities. In one report, more than half of the population of office workers studied reported musculoskeletal symptoms that they attributed to work.

In computer intensive office work, long exposure duration, repetitive movements, static and awkward postures, monotonous tasks with low physical demands and psychological conditions are important factors in the early stages of musculoskeletal disorders, particularly when workers are exposed to several risk factors simultaneously.

The most common health outcome of muscle disorders is a sensation of pain, when pain is defined as an unpleasant sensory experience with actual or potential tissue damage.

In “Massage Helps Address Major Corporate Kneads,” Margaret Littman, Crain’s Chicago Business (July 21, 1999). “[R]esearch from the University of Miami School of Medicine’s Touch Research Institute found that office workers who received regular massages were more alert, performed better and were less stressed than those who didn’t. Local managers tend to think […] that employees who are less stressed are more productive. Not only do they show up more often, but they are more effective while in the office.”

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June 21, 2011

Cervical status after neck sprains in frontal and rear-end car impacts

Filed under: Neck Pain,Whiplash — Administrator @ 3:48 am

Cervical status after neck sprains in frontal and rear-end car impacts

From: Injury. 2011 Jun 15. [Epub ahead of print]

In general, a strain is usually is a simple soft tissue injury of muscle. Unless the muscle is completely torn, it is usually self limiting and heals without complication, responding well to ice, rest and rehabilitative therapy.

A sprain can be a significant soft tissue injury, occurring in ligaments, and may be a non reversible permanent injury to the supporting structures to which ligaments connect. Ligament injuries (sprains) generally do not heal fully and may produce long term degenerative effects upon the tissues they are meant to support, and may lead to serious impairment of body parts.

Depending on the severity of the ligamentous lesions, sprains may be classified as either benign or severe. Benign sprains are due to a stretching or minimal tearing of the ligaments; they do not cause instability at the affected level. Severe neck sprains, on the other hand, are due to ligamentous tears, which cause instability. The diagnosis is based upon radiographic criteria. The distinction between the two grades of sprain may be difficult.

The purpose of this study was to compare the cervical status after neck sprains in frontal and rear-end car impacts with respect to earlier proposed neck sprain injury mechanisms, rotated head at impact, and the seat-belt geometry.

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June 18, 2011

Neck-upper extremity musculoskeletal disorders among workers in the telecommunications company at mansoura city

Filed under: Carpal Tunnel,Neck Pain,Posture,Shoulder Pain — Administrator @ 5:05 am

Neck-upper extremity musculoskeletal disorders among workers in the telecommunications company at mansoura city

From: Int J Occup Saf Ergon. 2011;17(2):195-205

Persisting neck pain is common in society. It has been reported that the prevalence of neck pain in office workers is much higher than in the general population. The costs to the worker, employer and society associated with work-related neck pain are known to be considerable and are escalating.

Neck and upper limb symptoms are frequently reported by computer workers. More than 50% of the computer workers report symptoms in neck, shoulders, arms, wrists or fingers. In the year 2002, 28% of the general Dutch working population suffered from pain or stiffness in the neck, shoulder, arms, hands or wrists in the previous 12 months. In Europe the prevalence for work-related neck/shoulder pain was 25% and 15% for work-related arm pain. The total yearly costs of neck and upper limb symptoms in the Netherlands due to decreased productivity, sick leave, chronic disability for work and medical costs were recently estimated at 2.1 billion euros.

The increase in computer and mouse use has been associated with an increased prevalence of disorders in the neck and upper extremities. Poor workstation design, continuous computer use for the entire workday and repetitive computer work, such as data entry, were associated with an increased risk of developing symptoms. It has also been shown that the musculoskeletal disorders associated with computer mouse use are increasing.

A positive relation has been found between various neck disorders and work related risk factors, such as static neck and arm postures, duration of sitting, as well as workplace design. Among other job characteristics, high quantitative job demands, having little influence on one’s work situation, and limited rest break opportunities have been found as predictors of neck pain.

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June 17, 2011

Patients With Temporomandibular Disorders Have Increased Fatigability of the Cervical Extensor Muscles

Filed under: Neck Pain,TMJ Pain — Administrator @ 4:13 am

Patients With Temporomandibular Disorders Have Increased Fatigability of the Cervical Extensor Muscles

From: Clin J Pain. 2011 Jun 14. [Epub ahead of print]

To determine whether patients with myogenous and mixed temporomandibular disorders have greater fatigability of the cervical extensor muscles while performing a neck extensor muscle endurance test when compared with healthy controls.

A total of 151 individuals participated in this study. Of these 47 were healthy controls, 57 patients had myogenous temporomandibular disorders, and 47 patients had mixed temporomandibular disorders. All patients performed the neck extensor muscle endurance test. The patients were instructed to maintain a prone lying position with the neck unsupported as long as possible, stopping at signs of fatigue or any discomfort.

Electromyographic activity of the cervical extensor muscles during the neck extensor muscle endurance test and the holding time were collected for all patients and were compared across groups. A 1-way analysis of variance was used to evaluate the differences in holding time between patients with temporomandibular disorders and healthy controls. A mixed model analysis was used to evaluate the differences in normalized median frequency at different times (fatigue index) for the cervical extensor muscles while performing the neck extensor muscle endurance test between patients with temporomandibular disorders and controls.

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June 15, 2011

The effect of cetylated fatty esters and physical therapy on myofascial pain syndrome of the neck

Filed under: Neck Pain — Administrator @ 3:15 am

The effect of cetylated fatty esters and physical therapy on myofascial pain syndrome of the neck

From: J Bodyw Mov Ther. 2011 Jul;15(3):363-74.

Participants with Myofascial Pain Syndrome (MPS) of the neck were randomly assigned into 2 groups of the double-blinded study: topical cetylated fatty ester complex cream application plus physical therapy (n=37), and placebo cream application plus physical therapy (n=35). There were 3 visits during 4 weeks of treatment. Physical Therapy, given twice/week, included Ischaemic Compression, Deep Pressure Trigger Point Massage and Myofascial Releases. Topical cream [cetylated fatty ester complex cream (5.6%) and 1.5% menthol] or placebo cream [1.5% menthol, in a cream base] was applied twice/day. Topical cetylated fatty ester complex cream application plus physical therapy provided the fastest and most effective study treatment modality. The addition of topical cetylated fatty ester complex cream to physical therapy resulted in statistically significant improvements, compared to placebo cream application plus physical therapy, for reduction of pain, neck disability and life quality indicators. Our results indicate that cetylated derivatives of fatty acids can effectively reduce pain and symptoms associated with neck myofascial pain syndrome, when combined with physical therapy.

June 13, 2011

Electromyographic Activity of the Cervical Flexor Muscles in Patients With Temporomandibular Disorders While Performing the Craniocervical Flexion Test

Filed under: Neck Pain,TMJ Pain — Administrator @ 2:47 am

Electromyographic Activity of the Cervical Flexor Muscles in Patients With Temporomandibular Disorders While Performing the Craniocervical Flexion Test: A Cross-Sectional Study.

From: Phys Ther. 2011 Jun 9. [Epub ahead of print]

Most patients with temporomandibular disorders have been shown to have cervical spine dysfunction. However, this cervical dysfunction has been evaluated only qualitatively through a general clinical examination of the neck.

The purpose of this study was to determine whether patients with temporomandibular disorders had increased activity of the superficial cervical muscles when performing the craniocervical flexion test compared with a control group of individuals who were healthy. Design A cross-sectional study was conducted.

One hundred fifty individuals participated in this study: 47 were healthy, 54 had myogenous temporomandibular disorders, and 49 had mixed temporomandibular disorders. All participants performed the craniocervical flexion test. Data for electromyographic activity of the sternocleidomastoid and anterior scalene muscles were collected during the craniocervical flexion test for all participants. A 3-way mixed-design analysis of variance for repeated measures was used to evaluate the differences in electromyographic activity for selected muscles while performing the craniocervical flexion test under 5 incremental levels. Effect size values were calculated to evaluate the clinical relevance of the results.

Although there were no statistically significant differences in electromyographic activity in the sternocleidomastoid or anterior scalene muscles during the craniocervical flexion test in patients with mixed and myogenous temporomandibular disorders compared with the control group, those with temporomandibular disorders tended to have increased activity of the superficial cervical muscles. Limitations The results obtained in this research are applicable for the group of individuals who participated in this study under the protocols used. They could potentially be applied to people with temporomandibular disorders having characteristics similar to those of the participants of this study.

This information may give clinicians insight into the importance of evaluation and possible treatment of the deep neck flexors in patients with temporomandibular disorders. However, future research should test the effectiveness of this type of program through a randomized controlled trial in people with temporomandibular disorders in order to determine the real value of treating this type of impairment in this population.

June 11, 2011

Headache and musculoskeletal complaints among subjects with self reported whiplash injury

Filed under: Chronic Pain,Headaches,Neck Pain,Whiplash — Administrator @ 4:35 am

Headache and musculoskeletal complaints among subjects with self reported whiplash injury. The HUNT-2 study.

From: BMC Musculoskelet Disord. 2011 Jun 8;12(1):129. [Epub ahead of print]

Whiplash injury occurs due to an acceleration-deceleration energy transfer to the neck resulting from motor-vehicle collisions, and the term whiplash associated disorders was introduced in order to describe the sign and symptoms associated with the injury.

The prognosis of whiplash injuries show highly variable results and may be due to differences in study populations and definitions of outcome. Usually the prognosis of whiplash is favorable and self-limited. The natural course for those that report symptoms after a whiplash trauma will in most cases be rapid improvement of pain and disability the first three months. Beyond three months there is usually little improvement. It is not clear which patients are at risk of delayed recovery following whiplash injury, but a slow or poor recovery of neck pain seems to be associated with psychological factors, compensation or legal factors and initial self reported symptom severity. The course of recovery in whiplash associated disorders is very similar to the course of neck pain in the general population.

Headache, neck pain and other subjective complaints are common in the general population, and both headache and neck pain are equally frequent in patients with and without a history of whiplash. Headache is commonly reported after a whiplash trauma, but the validity of the acute and chronic whiplash headache included in the ICHD-2 criteria are questionable and represents most likely occurrences of pre-accidental primary headaches like migraine and tension type headache, The prognosis of headache after a whiplash trauma is good and similar to non-traumatized controls.

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