Please enable JavaScript.
Coggle requires JavaScript to display documents.
Neck Pain, Red flags - Coggle Diagram
Neck Pain
Differentials
Acute disc prolapse
Adverse drug reactions
Acute trauma
Arthritis of the cervical spine
Acute torticollis (muscle spasm with no known cause)
Cervical strain/fracture/dislocation/myelopathy
Cervical radiculopathy
Fibromyalgia and psychogenic conditions
herpes zoster, osteomyelitis
Malignancy
Peripheral neuropathy
Assessment
?Previous injury or infection
?History of cancer
?PMH
Presence of fever
?Occupation
Symptoms of anxiety and/or depression
SOCTARES
decrease in sensation, or strength, or abnormal reflexes
Management
Red flag- Refer Urgently for immediate assessment
Acute neck pain < 6 weeks/ sub acute 6-12 weeks
Reassure
Consider topical NSAID
Analgesia
Encourage return to normal lifestyle
Avoid driving if ROM restricted
Discourage use of neck collar
Consider prescribing muscle relaxants
Advise use of firm pillow
Pain for > 12 weeks
Refer Pain clinic
Assess cervical radiculopathy
Spurling test
Arm squeeze test
Axial traction
Special maneuvers to identify
nuchal rigidity if meningitis
Kernigs sign
Brudzinski's sign
Signs and Symptoms of serious pathology
General
Fever
General neck stiffness
Lymphadenopathy
Nausea and Vomiting
Severe neck tenderness
Erythema/wounds/exudate
Uremitting, increasing pain +/- disturbs sleep
Weightloss
Neurological
Altered consciousness
Gait disturbance
Ataxia
Loss of sexual/bladder/bowel function
Altered muscle tone
New severe headache
Photphobia/phonophobia
Visual loss
Red flags