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Alan moelleken-md-santa-barbara-neck pain

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  • 1. Neck pain From Wikipedia, the free encyclopedia "Pain in the neck" redirects here. For the idiomatic expression, see wikt:pain in the neck. Neck pain (or cervicalgia) is a common problem, with two-thirds of the population having neck pain at some point in their lives.[1] Neck pain, although felt in the neck, can be caused by numerous other spinal problems. Neck pain may arise due to muscular tightness in both the neck and upper back, or pinching of the nerves emanating from the cervical vertebrae. Joint disruption in the neck creates pain, as does joint disruption in the upper back. The head is supported by the lower neck and upper back, and it is these areas that commonly cause neck pain. The top three joints in the neck allow for most movement of the neck and head. The lower joints in the neck and those of the upper back create a supportive structure for the head to sit on. If this support system is affected adversely, then the muscles in the area will tighten, leading to neck pain. Contents 1 Differential diagnosis 2 Treatment o 2.1 Conservative treatment o 2.2 Medication o 2.3 Surgery 3 Epidemiology 4 Prognosis 5 References Differential diagnosis Neck pain may come from any of the structures in the neck including: vascular, nerve, airway, digestive, and musculature / skeletal or be referred from other areas of the body. [2] Major and severe causes of neck pain (roughly in order of severity) include: Carotid artery dissection Referred pain from acute coronary syndrome Head and neck cancer Infections: retropharyngeal abscess, epiglottitis, etc.[3] Spinal disc herniation – protruding or bulging discs, or if severe prolapse. Spondylosis - degenerative arthritis and osteophytes Spinal stenosis – a narrowing of the spinal canal The more common and lesser neck pain causes include: Stress – physical and emotional stresses Prolonged postures – many people fall asleep on sofas and chairs and wake up with sore necks. Minor injuries and falls – car accidents, sporting events and day to day injuries that are really minor. Referred pain – mostly from upper back problems Over-use – muscular strain is one of the most common causes Whiplash Herniated disc[4] Pinched nerve Although the causes are numerous, most are easily rectified by either professional help or using self help advice and techniques.
  • 2. More causes include poor sleeping posture, torticollis, head injury, rheumatoid arthritis, Carotidynia, congenital cervical rib, mononucleosis, rubella, certain cancers, ankylosingspondylitis, cervical spine fracture, esophageal trauma, subarachnoid hemorrhage, lymphadenitis, thyroid trauma, and tracheal trauma. Treatment Treatment of neck pain depends on the cause. For the vast majority of people, neck pain can be treated conservatively. Recommendations which help alleviate symptoms include applying heat or cold. [5] Other common treatments could include medication, body mechanics training, ergonomic reform, or physical therapy. Conservative treatment Exercise plus joint mobilization and/or joint manipulation (spinal adjustment) has been found to be beneficial in both acute and chronic mechanical neck disorders.[6] Both cervical manipulation and cervical mobilisation produce similar immediate-, and short-term changes; no long-term data are available.[7] Thoracic manipulation may also improve pain and function. [7][8] Low level laser therapy has been shown to reduce pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain.[9] Medication Analgesics such as acetaminophen or NSAIDs are recommended for pain.[10]Muscle relaxants are often prescribed and are known to be effective. However, one study showed that one muscle relaxant called cyclobenzaprine was not effective for treatment of acute cervical strain (as opposed to neck pain from other etiologies or chronic neck pain).[11] Over the counter topical creams and patches may be effective for some patients. Surgery Surgery is usually not indicated for mechanical causes of neck pain. If neck pain is the result of instability, cancer, or other disease process surgery may be necessary. Surgery is usually not indicated for "pinched nerves" or herniated discs unless there is spinal cord compression or pain and disability have been protracted for many months and refractory to conservative treatment such as physical therapy. Epidemiology Neck pain affects about 330 million people globally as of 2010 (4.9% of the population). [12] It is more common in women (5.7%) than men (3.9%).[12] It is less common than low back pain.[13] Prognosis About one-half of episodes resolve within one year.[1] About 10% of cases become chronic.[1] References 1. 2. 3. ^ Jump up to: abc Binder AI (2007). "Cervical spondylosis and neck pain". BMJ334 (7592): 527– 31. doi:10.1136/bmj.39127.608299.80. PMC 1819511. PMID 17347239. Jump up ^AmalMattu; DeepiGoyal; Barrett, Jeffrey W.; Joshua Broder; DeAngelis, Michael; Peter Deblieux; Gus M. Garmel; Richard Harrigan; David Karras; Anita L'Italien; David Manthey (2007). Emergency medicine: avoiding the pitfalls and improving the outcomes. Malden, Mass: Blackwell Pub./BMJ Books. p. 46. ISBN 1-4051-4166-2. Jump up ^AmalMattu; DeepiGoyal; Barrett, Jeffrey W.; Joshua Broder; DeAngelis, Michael; Peter Deblieux; Gus M. Garmel; Richard Harrigan; David Karras; Anita L'Italien; David Manthey
  • 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. (2007). Emergency medicine: avoiding the pitfalls and improving the outcomes. Malden, Mass: Blackwell Pub./BMJ Books. p. 47. ISBN 1-4051-4166-2. Jump up ^ Dr. Kevin Yip (2009). A Guide to Common Orthopaedic Problems. Singapore, Mass: Singapore Sports and Orthopaedic Clinic. p. 180. ISBN 1-4051-4166-2. Jump up ^Garra, Gregory; Singer, Adam J. et al. (2010). "Heat or Cold Packs for Neck and Back Strain: A Randomized Controlled Trial of Efficacy". Academic Emergency Medicine17 (5): 484– 9. doi:10.1111/j.1553-2712.2010.00735.x. PMID 20536800. Jump up ^"BestBets: Manipulation and/or exercise for neck pain?". ^ Jump up to: ab Gross AR (2010). "Manipulation or mobilisation for neck pain". Cochrane database of systematic reviews (Online) (1): CD004249. doi:10.1002/14651858.CD004249.pub3. PMID 20091561. Jump up ^Huisman PA, Speksnijder CM, de Wijer A (January 2013). "The effect of thoracic spine manipulation on pain and disability in patients with non-specific neck pain: a systematic review.".DisabilRehabil. doi:10.3109/09638288.2012.750689. PMID 23339721. Jump up ^ 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". Lancet374 (9705): 1897–1908. doi:10.1016/S0140-6736(09)61522-1. PMID 19913903. Jump up ^"UpToDate Inc.". Jump up ^Khwaja SM, Minnerop M, Singer AJ (January 2010). "Comparison of ibuprofen, cyclobenzaprine or both in patients with acute cervical strain: a randomized controlled trial". CJEM12 (1): 39–44. PMID 20078917. ^ Jump up to: abVos, T (2012 Dec 15). "Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.".Lancet380 (9859): 2163–96. doi:10.1016/S0140-6736(12)61729-2. PMID 23245607. Jump up ^Deen, Hanifa;Bartleson, J. D. (2009). Spine disorders medical and surgical management. Cambridge, UK: Cambridge University Press. p. 3. ISBN 0-521-88941-3. SANTA BARBARA BEST SPINE AND ORTHOPEDIC DOCTORS IN CALIFORNIA 401 East Carrillo Street, Santa Barbara, CA 93101 PH 805-563-3307 FAX 805-563-0998 Attending Staff  Alan Moelleken, MD  Michael Price, MD  Michael Kenly, MD  David Lee, MD  David Pires, DO  Ken Nisbet, PA-C, MSPAS  Jesse Jacobs, PA-C, MSPAS  Darren Richards, PA-C, MSPAS  Matt Ebling, PA-C, MSPAS
  • 4.  Andrew Fairburn, PA-C  Jessica Jacobs, PA-C  Mitch Fallon, PA-C  Andrea Lewis, LAc SANTA MARIA BEST SPINE AND ORTHOPEDIC DOCTORS IN CALIFORNIA 326 West Main Street, Suite 120 Santa Maria, CA 93458 PH 805-925-9997 FAX 805-925-9988  Alan Moelleken, MD  Michael Price, MD  Michael Kenly, MD  David Lee, MD  David Pires, DO  Ken Nisbet, PA-C, MSPAS  Terry Brightwell, DC  Jesse Jacobs, PA-C, MSPAS  Darren Richards, PA-C, MSPAS  Matt Ebling, PA-C, MSPAS  Andrew Fairburn, PA-C  Jessica Jacobs, PA-C  Mitch Fallon, PA-C  Tona Marquez, LAc BAKERSFIELD BEST SPINE AND ORTHOPEDIC DOCTORS IN CALIFORNIA 2725 16th Street Bakersfield, CA 93301 PH 661-864-1150 FAX 661-864-1145 Attending Staff  Alan Moelleken, MD  Michael Price, MD  Michael Kenly, MD  David Lee, MD  David Pires, DO  Tony Kim, DC  Adam Sverdlin, DC
  • 5.  Jesse Jacobs, PA-C, MSPAS  Darren Richards, PA-C, MSPAS  Matt Ebling, PA-C, MSPAS  Andrew Fairburn, PA-C  Mitch Fallon, PA-C  Jen Lewis, PA-C, MSPAS  Kerby Pierre-Louis, PA-C  Darla Kyle, PA-C  Avis Chiu, LAc OXNARD BEST SPINE AND ORTHOPEDIC DOCTORS IN CALIFORNIA 640 South B Street Oxnard, CA 93030 PH 805-485-7042 FAX 805-485-0716 Attending Staff  Alan Moelleken, MD  Michael Price, MD  Michael Kenly, MD  Adam Sverdlin, DC  Daniel Chang, DC  Ken Nisbet, PA-C, MSPAS  Jesse Jacobs, PA-C, MSPAS  Darren Richards, PA-C, MSPAS  Matt Ebling, PA-C, MSPAS  Andrew Fairburn, PA-C  Mitch Fallon, PA-C  Kerby Pierre-Louis, PA-C  Jaewoo You, LAc  Darren Lisle, LAc VAN NUYS BEST SPINE AND ORTHOPEDIC DOCTORS IN CALIFORNIA 6326 Vesper Ave Van Nuys, CA 91411 PH 818-779-1500 FAX 818-779-1551
  • 6. Attending Staff  Alan Moelleken, MD  Michael Price, MD  David Lee, MD  Paul Cabrera, DC  Jen Lewis, PA-C, MSPAS  Kerby Pierre-Louis, PA-C  Jesse Jacobs, PA-C, MSPAS  Jaewoo You, LAc SANTA BARBARA BEST SPINE AND ORTHOPEDIC DOCTORS AT THE SPINE AND ORTHOPEDIC PHYSICAL REHABILITATION CALIFORNIA 119 N Milpas Santa Barbara, CA 93103 PH 805-730-1914 FAX 805-963-7550

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