The mechanism of injury can be interpreted by asking about the mode of injury such as fall by asking about the mode of injury ,such as fall from height, road traffic accident, position of the limb or body at the time of injury, any rotational force acting on the body and the type of activity done by the time of  injury.

The mechanism of injury, site of injury, pain and disabilities should be interpreted from the history.

Examination

Inspection: The patient should be examined in sitting position with his upper torso and upper limbs exposed upto the waist.

Attitude: The position of the limb on inspection should be noted. In fractures of clavicle and anterior dislocation of shoulder, the patient often supports the injured limbs with the other hand. The arm segment may appear short or long depending on in fracture neck of scapula, there will be lengthing of the arm.

Swelling or deformity: In anterior dislocation of shoulder, the anterior axillary fold may be abnormally prominent due to the presence of head of humerus. A swelling along the line of clavicle, diffuse swelling surrounding the proximal humerus may be seen in fractures of the underlying bones. The lateral end of clavicle may appear to be prominent in acromioclavicular joint injuries. The medial end of clavicle may be seen prominently in sternoclavicular injuries.

Shoulder contour: Normally, the shoulder has a round contour due to prominence of the greater tuberosity beneath the deltoid muscle. The greater tuberosity projects beyond the edge of acromion process giving the normal contour. In dislocation of the shoulder joint, due to loss of projection of greater tuberosity, the normal contour will be lost. This is a valuable sign of dislocation. In deltoid paralysis due to axillary nerve injuries, there may be wasting of the muscle causing apparent loss of contour of the shoulder. The shoulder contour may be masked by diffuse swelling associated with fractures of the proximal humerus.

Bony arch: The bony arch is formed by the clavicle, acromion process and spine of scapula. Any deformity in the bony arch should be noted for.

Palpation

The bony points to be palpated are: clavicle, proximal humerus, acromion process, spine and borders of scapula for signs of fracture.

Clavicle: By standing behind the sitting patient, the examiner places both his hands on the medial end of clavicle and runs his fingers along the shaft of both the clavicles. Any irregularity, gap or crepitus should be looked for. In acromioclavicular joint dislocation, the lateral end of clavicle may be displaced upward. On pressing the lateral end of clavicle, it depresses and bounces back like a piano key.

Proximal humerus: By standing on the side of the patient, the elbow is flexed and the proximal humerus is palpated bimanually by keeping one hand and the medial surface of arm and other on the outer surface of the arm. By standing behind the patient, the examiner slides his fingers down from the acromion process to the arm to palpate the greater tuberosity and proximal humerus. If the head of humerus is in normal position, then there will be a bony resistance to palpation. In dislocations, there will be an empty feeling in the shoulder region. The head may be palpable in either of axillary folds. Diffuse tenderness may be present in fractures of proximal humerus. In an intact humerus, the medial epicondyle will be in the same direction as that of the head of humerus.

Scapula: The acromion process and spine of scapula are palpated for irregularity, bony tenderness and crepitus. The axillary and vertebral borders are palpated for signs of fracture. The coracoids process is situated half an inch below the clavicle at its junction with medial two third and lateral one third. Fracture neck of scapula is diagnosed by axial pressure applied through the arm with the elbow flexed.

Movements

Both active and passive movements of the shoulder should be tested. In anterior dislocation of the shoulder, the patient will not be able to touch the opposite shoulder with his hand of affected extremity. This is called Dugas test.

Tests for detecting anterior dislocation of shoulder:

Hamilton ruler’s test: In normal persons, a straight ruler cannot be placed between the acromion process and lateral epicondyle because of the presence of greater tuberosity in its normal position. In dislocation of the shoulder, a ruler can be placed.

Callaway’s test: The vertical circumference of the axillary is increased in dislocation of shoulder due to the presence of head in the anterior axillary fold.

Measurements

The length of the arm is measured from the angle of acromion process to the lateral epicondyle.

Neurological examination: In fracture of the clavicle, brachial plexus may be injured. In fractures and dislocations of humorous, axillary nerve may get damaged. Axillary nerve damage may manifest as paralysis of deltoid muscle and anesthesia in skin over the lower part of deltoid muscle.

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FACET JOINT STRAIN

Pain often occurs when one of the Facet Joints that the vertebrae in your spinal column is suddenly twisted or jerked. A joint that is damaged in this way may stick or “lock”, making movement difficult as well as painful. Facet joint strain can occur throughout your spine.

CAUSES

Awkward twisting or bending of your neck or back can injure the ligaments, muscles, or the capsule of a facet joint whiplash from a car accident is a good example of this type of injury ,  but it can also result from failure to warm up before exercising or playing sports, or from lifting heavy objects. Even simply turning over in bed or sleeping awkwardly can have the same effect. Your muscles may then go into an uncontrollable spasm, making the joint stiff immobile. Facet joints are more vulnerable to strains from middle age onward, when  osteoarthritis may flare up, the disks in your spine have degenerated significantly and the ligaments that are supporting the joints become more slack.

SYMPTOMS AND DIAGNOSIS

In the early stages,disabling pain in your neck or back is often accompanied by pain in your accompanied by restricted movement.Pain from facet joint strain in your lower back  may also radiate into your buttocks,hips,lower abdomen and thighs.Movement may be limited for only a few weeks however it can last for months and in some cases years . unless you receive appropriate treatment, which usually involves manipulation or in chronic cases, an injection.Facet joint starin in your neck may extend down to your neck may extend down to your shoulders, making it difficult to bend your neck or turn shoulders making it difficult to bend your neck or turn your head.Your doctor or therapists will make a diagnosis by giving you a physical examination.

RISKS AND RECOVERY

There is no serious risk from facet joint strain, but failure to relieve pain or inflammation can lead to permanently stiff joints starin in the middle of your back although the least common, may cause pain to radiate around your chest, making it painful and difficult to breathe, especially if the joints between the ribs and thoracic vertebrae become “locked”.

VERTEBRAL COMPRESSION FRACTURE

Weakening of the bones is fairly common in old age and may also occur in younger people who are in poor health. When this loss of structural strength affects the vertebrae of the spinal column, even a slight increase in pressure on them- perhaps due to a fall or sudden vigorous activity-can cause cracks and fractures, especially in the middle and lower back.

CAUSES

Osteoporosis is the most common cause of bones (including the vertebrae) becoming weaker and more susceptible to injury. The condition causes loss of minerals from the bones, women after menopause due to hormonal changes. but men also develop osteoporosis  to some degree as they age if you  are a heavy smoker or heavy drinker do little exercise or have suffered from an eating disorder(such as anorexia) and  an still underweight and very thin, you have a high risk of developing osteoporosis  . In a few causes, taking steroids for a particular medical condition may weaken your bones, as can certain forms of cancer.

 SYMPTOMS AND DIAGNOSIS

 If you fracture a vertebra you will feel a sudden , servere pain in the area of your back where the injury has occurred .Damaged vertebrae in your lower back may also cause pain around your pelvis, and if any nerves are irritated, numbness and tingling in your legs. In the upper part of your back the pain may radiate around your chest and make breathing difficult. You may find it hard to move around and even lying down can cause pain coughing or sneezing may hurt too. This pain and lack of mobility it surely to take several weeks to subside. Your doctor may arrange for a CT or an MRI scan to assess the extent of the fracture.

RISKS AND RECOVERY

Although compression fracture in the spine usually heal within a matter of weeks without any special treatment the shape of your spine and your posture may be permanently affected while the pain lasts you are likely to find it difficult to perform everyday activities.

SARCROILIAC STRAIN

 Located on either side of your spine at the very bottom of the back’ the sacroiliac joints link your sacrum (the fused bones at the base of your spine) to your hip bones’ forming the rear part of your pelvic girdle. They allow the twisting movements of your legs when you walk or run. Problems arise when they either become “locked”, restricting movement, or too mobile.

CAUSES

Sacroiliac strain is usually the result of a sudden impact, such as a heavy blow or fall, which damages the ligamentssupporting the joint. Sudden, unexpected twisting or bending movements, where your muscles are unprepared is absorbed by the ligaments, can have the same effect. Mechanical charges in these joints may also over a period of time due to an imbalanced used of surrounding muscles, abnormalities (such as a slight difference in leg length), orosteoarthritis. Strained ligaments lead to loosening of the joints, making them more mobile. It is also common for pregnant women. To suffer from hyper mobile sacroiliac joints, because of hormonal changes that soften and slacken the ligaments of the pelvis in preparation for giving birth.

SYMPTOMS AND DIAGNOSIS

You will feel a sharp pain in the upper inner part of your buttock when you put your foot down, making walking or running very uncomfortable. There will also be dull pain radiating deep into your lower buttock; sometimes you will also experience referred pain in your legs. Movement of your leg may be restricted, which will also make walking difficult. Your doctor may use MRI scans or X-rays  to identify any inflammation cause of your symptoms. If inflammation is present, you may be given a blood test to check if this is being caused by an infection.

RISKS AND RECOVERY

If you sit still or lie down for a long time, you may feel stiffness and immobility. Ligaments take longer to heal than fractured bone, and may fail to heal completely

Ankylosing Spondilitis (AS) tends to occur in you adults, and usually effects men more severely than women. A form of spinal arthritis, it leads to inflammation and a classification, or hardening, of the ligaments in the sacroiliac joints and in the intervertebral joints that link the vertebrate together. It is also known as Marie-Strumpell or Bechterev’s disease.

CAUSES

Generally, sufferers of Ankylosing Spondilitis are genetically predisposed toward the disease. Little is known about what causes it, although it is known to be an autoimmune disease, which means that the body’s immune system not only fights invading infections but also attracts the body’s own cells. It is thought that AS may start when an immune response to bacteria or a virus continues once the infection has gone.

SYMPTOMS AND DIAGNOSIS

The onset of the disease usually occurs between and mid-teens and the mid-30s. It affects the sacroiliac joint first, and will cause pain and stiffness in your lower back and buttocks that is worse on waking. You may find it difficult to bend forward and your hips joints will be stiff. It advances gradually over several years into the thoracic and cervical spine, causing pain and the stiffness in the rest of your back and neck. Extreme stiffness can result in you hunching forward, flattening your chest and curving your spine. In some people, the inflammation and calcification may eventually affect the joints between the ribs and the mid-spine so that movement of the rib cage is limited, impairing breathing. Your doctor will make a diagnosis by considering your symptoms and performing tests, including blood tests, X-rays and MRI scan, and ultrasound.

RISK

It is important to identify and treat the condition as early as possible to prevent irreversible deterioration in posture and mobility. People with Ankylosing Spondilitis have an increased risk of osteoporosis in the spine and of heart and circulatory problems, such as stroke.

TREATMENT:

Treatment includes physical therapy, exercise, and medication. Physical therapy shown to be of great benefit to AS patients.  Swimming is also one of the preferred exercises since it involves all muscles and joints in a low-impact. Yoga and Jogging are available to reduce symptoms and pain of Ankylosing Spondilitis.

(Heel Pain) Plantar fasciitis may be your problem.

Heel pain is one of the most familiar situations that a lot of patients complain about. Several factors are responsible for this condition. Plantar fasciitis is the most general cause of pain felt in the heel. “Plantar” means the bottom of the foot, “fascia” is a type of connective tissue, and “itis” means “inflammation” This is also referred to as the heel spur syndrome if there is a presence of spur. This condition may also be caused by arthritis, tendonitis, nerve irritation, and stress fracture.

During Heel pain caused by planter fasciitis, the band of tissue expanding from the heel point to the toe tip becomes swollen. In this condition, the tight tissue forming the curve of the foot is first annoyed and will then result in swelling.

Risk factors for plantar fasciitis are

• excessive running
• high arch
• when one leg is longer than the other
• obesity
• occupations with prolonged standing or walking
• sedentary lifestyle
• Achilles tendon tightness

Treatment can be done according to the phases.  Initial treatment should be tried for a few weeks and then should continue with further phases of treatment. Following are some effective treatments.

Tape can be used to give the face rest without reducing activity.  Athletic tape can be bought at all pharmacies. Tape can be the cure in the severe case which can result a sudden increase in weight. Losing weight, ice, and stretching can also cure chronic  pain.

•  If heel pain persists, then physical therapy, foot orthotics, and night splinting may be needed.

•  Stretching the calf muscles without reinjuring the fascia before getting out of bed in the morning and a few times per day is well-known to be a cure for many patients.

• Ice is a miracle cure for soft-tissue injuries.  Ice is not only great for professional football players with knee or shoulder injuries, but also for desk-jockeys who can’t seem to get rid of their heel pain.  It was ranked the third best treatment by our visitors. Applying ice after activity or injury is crucial.  It may be beneficial to apply it up to 5 times a day.

• Physical therapy exercise is one of the best cures for heel pain. But be sure, exercises should be done under experienced physical therapist. When done properly and consistently, physical therapy can help prevent permanent relief from your pain.

90% of patients will improve with the above techniques.  Pain lasting 6 months despite therapy may require shock wave therapy.

Are you suffering from pain during or after sitting?

Pain in the buttocks commonly emanates from the spine, but can also stem from the sacroiliac joints and ligaments, and the muscles and bursae –fluid –filled sacs-of the hip. Most pain in the tail bone area originates in the coccyx.

Causes For Buttock and Coccyx pain

Lumbar and lower thoracic sources such as facet joist, disks, nerves and even muscles can produce pain in this area. Injuries to the lower thoracic vertebrae such as compression fractures also create pain lower down the back. The sacroiliac joint and ligaments of the pelvis can cause pain more locally-deep into the buttock, sometimes to the side of the hip and groin, and occasionally down the leg. Buttock muscles may develop tension, trigger points and tears and can rub the bursae between layers, leading to bursitis-inflammation of the bursa-in the side of the hip. The gluteus medius muscle can tighten and cause hip and buttock pain. The tail bone or coccyx can be painful long after a fall or blow, while the hip joint and associated structures such as the labrum can cause buttock pain.

Symptoms

Lumbar spine nerve-root irritation can radiate to your buttock, and may cause piriformis syndrome. Sacroiliac pain can cause spontaneous, severe pain in inflammatory conditions. Mechanical pain from the joint and ligaments is common and may rise from a fall, or more progressively from ligament laxity during pregnancy or often childbirth. It causes aching pain with sharp stabs, locking sensations, and a sense of instability and may interfere with walking-see hypermobility. Muscle dysfunction may also arise due to overload from sport, or from asymmetrical back, hips, or legs causing a dull ache that worsen the exercise. If hip is the source, walking or running will cause aching, stiffness and pain at night. Bursitis in the hip causes pain from pressure-lying, walking and sitting; coccydynia is painful mainly when sitting.

RISKS AND COMPLICATIONS

The main risk here is incorrect diagnosis: treatments for inflammatory and mechanical condition are quite different. Cancer from the pelvic organs can spread to the bony structure, so ruling out more serious problems is vital.

Physical Therapy for Buttock and Coccyx pain

Once your doctor has referred you, your therapist will perform a thorough assessment. Depending n the assessment your therapist may:

• Perform manual therapy such as manipulation of the coccyx, massage, and stretching of the ligaments attached to the coccyx.

• Perform electrotherapy or acupuncture.

Your therapist may advise you to:

• Sit only for short periods of time and use a coccyx cushion to take the pressure off your tail bone. If you do not have a cushion, you can roll up a towel or fold a pillow.

• Apply ice packs for the first few days after the pain starts,

• Apply heat packs after the few days, several times a day.

• Take stool-softening medication and increase fiber and water intake in order to reduce the pressure on your coccyx during bowel movements

Once your pain has reduced, you may:

• Start a rehabilitation program.

You therapist may advice you to:

• Perform seated-to-seated chair squats, clams, McKenzie extensions; leg raises side-lying leg raises, one-leg circles, and supine and kneeling pelvic tilts.

You May:

• Start low-impact cardiovascular training on the cross-trainer or in the water in the form of aqua aerobics

• Perform deep breathing and relaxation exercises.

Once you are nearly pain-free you may:

• Increase the impact of cardiovascular training such as jogging or running on the treadmill, cycling and aerobics.

• Continue strengthening your hip with leg raises, side –lying leg raises and adductor lifts.by gradually adding weights to your legs, such as ankle weights.

• Continue stretching your back, hip flexors and extensors with knees-to-chest stretches, McKenzie extenshions, kneeling hip flexors and hamstring flexors.

• Resume sports, gradually increasing the load and duration

Some diseases involve the whole spine or develop suddenly in a specific area for example as a result of an osteoporotic compression fracture. Other conditions develop gradually and cause symptoms in several areas such as postural pain and muscle tension, scoliosis and hypermobility syndrome.

Causes

The causes of a problem that affects the whole spine depend on the specific condition. The spine is a single functioning unit with 25 mobile segments, controlled by muscles that can span nearly its whole length as a result a condition that starts at the bottom can spread upward involving new areas of the spine by a chain reaction. Furthermore, the joints of the spine are made of the same tissues as other joints in the body, so an inflammatory disease can involve several joints. In addition bones lose mineral content with age and progressively weaken as a result.

Symptoms

Symptoms of postural disorders or advanced scoliosis that affects the whole spine will vary from pain and aching due to sustained contraction of muscles, fascia and ligaments being stretched or strained. In inflammatory disorders aching is symmetrical or strained. In inflammatory disorders aching is symmetrical and is usually worse in the morning or after a period of inactivity. In osteoporosis there are no symptoms apart from a gradual change in posture until a trivial fall or knock causes a vertebra to collapse producing intense pain. Hypermobile joints will seem to keep “catching” and clicking and will feel unstable.

Risks and Complications

The risks are related to the condition that is causing your symptoms. Some spinal pains are part of a chronic pain condition called fibromyalgia which involves other regions of the body. A diagnosis of fibromyalgia will prevent you from receiving unnecessary and excessive localized treatment. Some metabolic conditions such as vitamin D deficiency may cause widespread aching and this requires careful medical screening.

Physical Therapy for Whole Spine Conditions

Once your doctor has referred you your therapist will perform a thorough assessment. Depending on the findings of the assessment your therapist may:

• Perform soft-issues massage, passive mobilizations and postural taping.
• Teach you about posture and ergonomics.
• Begin functional retraining.

You may begin:

• Mobilizing exercises such as Mckenzie extensions, seated and lying trunk rotations.
• Strengthening exercises such as four-point supine knee lifts, kneeling supermans and calms.
• Stretching exercises such as knees-to-chest stretches, side glides, levator scapulae stretches, seated back extensions, seated waist extensions and seated twist extensions.

If you have a lot more mobility and less pain and have modified your daily activities to prevent postural strain, your therapist may advice you to:

• Move from moderate core-strengthening exercises to high-level exercises such as curl-ups, Swiss ball twists, side crunches, prone arm and leg lifts planks from knees, single leg bridges and side planks.
• Begin functional training such as squats, stationary lunges, forward lunges, reverse lunges with knee lifts and walking lunges.
• Begin sensorimotor training such as single-led stands.
• Begin cardiovascular training by using a cross-trainer or running on the treadmill or outdoors.

If you now have no pain and a full range of movement in your back, your therapist may advice you to:

• Begin more intense strengthening exercises such as prone breast stroke, Swiss ball side crunches, Swiss ball side crunches with twists and Swiss ball back stretches.
• Begin swimming, tai chi or pilates.

At the clinic, we see more clients with herniated disks than with any other back pain symptom.

Herniated Disk:  A herniated disk occurs when all or part of a spinal disk is forced through a damaged part of the disk. This places strain on nearby nerves. Disk herniations occur mostly in middle-aged and older men, particularly those concerned in tiring physical activity.

Many of them bring X-rays that show that the disk – a rough pad of tissue that acts as a cushion between vertebrae- has been squeezed by the bones until it comes into contact with the nerve. The disk is either bulging like a balloon that is being squeezed, or it actually ruptures with its softer inner core material oozing out like a jelly doughnut leaking its filling. All these are the symptoms of herniated disk.

Exercises

There are five exercises that are mitigating musculoskeletal pain in the low back.

•        Sitting Knee Pillow Squeezes

Description

 ¨     Sit right on the edge of a bench with your feet flat on the floor, hip width apart, toes pointing straight ahead.

¨     Position a pillow between your knees

¨     Rotate your hips ahead to place a curve in your low back and hold this pose     throughout the exercise.

¨     Squeeze and free the pillow with your knees

¨     Repeat as directed and do the squeezes slowly and evenly on both sides.

Purpose: This exercise strengthens the hip’s abductor/adductors to help pull the back of flexion.

•        Static Back Knee Pillow Squeezes

Description

¨     Lie down on your back with your legs up over a block

¨     Position a pillow between your knees

¨     Set your arms out to the sides at 45 degrees from your body with palms up

¨     Loosen up your upper back

¨     Using your inner thigh squeeze the pillow and release evenly.

¨     Feet remain parallel to one another.

¨     Relax your stomach and do not contract your stomach muscles while squeezing

Purpose: This exercise stabilizes the pelvis bilaterally. It allies the adductor adductors with the force of gravity and disengages the lower extremities.

•        Modified Floor Block

Description

¨     Lie on your stomach with your forehead on the floor.

¨     Your feet should be pigeon-toed and the buttocks relaxed.

¨     Rest your elbows on blocks so that the arms and hands are in the “Don’t shoot, sheriff- I give up” position.

¨     Make sure your shoulders are level from right to left. Breathe deeply, and relax the upper body.

¨     Do not press your arms into the blocks; let the chest and stomach fall into the floor, and that will cause the hips to tilt forward.

¨     Hold the position for six minutes.

Purpose:  This exercise loosen the shoulders.

•        Static Extension

Description

 ¨     Start down on the floor on your hands and knees with your main joints aligned (i.e. shoulders should lie straight above elbows and wrists, hips directly above knees)

•   Hands should be placed shoulder width apart, palms flat with fingers pointed straight ahead.

•   Arms must remain straight, elbows locked

¨     Walk your hands about six inches forward and then move your upper body forward so that your shoulders are again above your hands but now your hips are forward of your knees about six inches

¨     Loosen up your low back allowing it to arch with the movement coming from the slope of your pelvis

¨     Collapse your shoulder blades together and fall your head down

•   Your shoulders should be directly above your hands

•   If your low back begins to hurt, back your hips up toward your knees; this will make the exercise a bit easier

¨     Do as directed.

Purpose: Generally, extreme flexion causes a herniated disk, and this E-cise promotes, as name implies, extension, relieving the pressure on the disk. This exercise allows the back to sway and restore the missing lumbar arch.

•      Air Bench

Description

¨     Stand with your back to the wall.

¨     Push your hips and minute of your back into the wall.

¨     Position your feet forward and at the same time sliding down into a sitting position.

¨     Stop when you reach a ninety-degree angle.

¨     Knees should be placed over the ankles.

¨     Push the low back and mid back beside the wall to feel the quadriceps working along the top of the thigh.

¨     Hold for one or two minutes.

Purpose:  This exercise re-links the ankles, knees and hips.

•        Supine Groin Stretch

 Description

 ¨     Lie down on your back in the supine groin position with one leg straight out on the floor and the other leg on a block with the knee bent at 90 degrees

¨     Relax your upper body with your arms placed 45 degrees with body with your palms facing upwards.

¨     Flatten your leg and tighten your thigh.

¨     Notice which part of your body feel contraction or tightening of the muscle.

¨     Loosen up the thigh tightening for five minutes and recheck ones more at next five minute point. The contraction should be at the upper part of  the leg this time and with each successive test

¨     Relax then repeat on other leg

Purpose: This exercise promotes an elongation of hip and groin muscles. The result of this action will generate a chain result of muscular response in the upper body

If the pain continues undiminished, do only Supine Groin Stretch and Air Bench; the lingering pain is telling us that we first remove the extra rotation from the hips. After about a week, try including the first five items, adding one or two at a time every couple of days. Back pain is a symptom of conditions that have been developing from years. It will take more than a few minutes to get results and some of the exercises, since they work on different muscles and functions, may take longer than others.

Acute neck and nerve root pain describes several conditions that effect the cervical spine region and can also cause head pain. In the long term, it is rarely as disabling as low-back pain, but the severity of acute nerve-root pain can be just as bad as sciatica.

CAUSES

The pain can be caused by sprain of the facet joints and ligaments and disk herniation. Muscular Pain is more of a chronic condition but can flare up. Your neck is also vulnerable to external indirect trauma as in whiplash syndrome. When acute neck pain arises spontaneously in young adults or youngsters it is called acute torticollis. Disk prolapsed with nerve-root compression is the cause of the most severe pain.

SYMPTOMS

You may feel sharp pain, centrally or to one side of the neck with intense dull aching that can spread further into the shoulder blade area and halfway down the thoracic spine. You may have the stiffness being trapped by muscle spasm movements such as bending forward, backward, sideways or rotating. You may also find it hard to sit in a car or at computer for long periods. The Pain is often troublesome at night and lying down may make it worse. If a nerve is compressed or irritated, a sharp pain will radiate down your arm as far as your hand, accomplished by sensory disturbance such as pins and needles or numbness. If your motor nerve fibers have been damaged, you may develop weakness in your upper arm and forearm.

RISKS AND COMPLICATIONS

The risk of serious consequences of acute neck pain is extremely small. Usually the pain eases over a few weeks without specific treatment. The main risk lies in too much rest, the fear of triggering pain through everyday movements, and the idea that more pain means further harm, because these can lead to loss of confidence and mobility. If you have developed pain after direct trauma, such as a blow to the back of neck, then you should obtain immediate medical advice.

 Cervical Nerve Root Neck Pain Treatment by Physiotherapy

Once your doctor has referred you, your therapist will perform a thorough assessment. Depending on findings of the assessment, your therapist may:

•  Perform soft-issue mobilization, gentle spinal joint mobilizing and manual traction of the involved segment.
• Teach you how to perform active joint-mobilization in a supine position.

Your therapist may advise you to:

•  Avoid activities such as blending, lifting, carrying, straining, and prolonged sitting.
• Use laxatives to avoid straining during bowel movements.
•  Practice breathing from your diaphragm to ease the pressure on your cervical spine.

If you have arm or hand pain or other neurological symptoms, you may be suffering from cervical radiculopathy. You will be advised to rest your neck to relieve compression of the spine.

After a few days or weeks, depending on your symptoms, your therapist may:

•  Suggest further passive and active mobilizations to increase the range of movement in your neck.
•  Advise you to perform self-positional tractions between treatments.

After your symptoms have subsided, you may be ready for more vigorous stretching exercises in weight-bearing positions. Your therapist may advise you to perform shoulder rotations, neck rotations, passive and active neck retractions, seated shoulder squeezes. As your pain diminishes you may introduce flexion and extension exercises such as towel neck flexions and towel neck extensions without causing pain.