Please enable JavaScript.
Coggle requires JavaScript to display documents.
Neck Pain - Coggle Diagram
Neck Pain
Differential Diagnosis
-
-
-
-
-
Cervical strain, fracture, dislocation, myelopathy
-
-
-
-
-
-
-
-
-
-
Red flags
Cervical myelopathy
-
-
-
-
-
Babinski's sign: up-going plantar reflex, hyper-reflexia, clonus, spasticity.
Lhermitte's sign: flexion of the neck causes an electric shock-type sensation that radiates down the spine and into the limbs.
Hoffman's sign: involuntary flexion and adduction of the thumb and flexion of the index finger when the nail of the middle finger is flicked downwards. (Not reliable in isolation as may be present normally).
More severe symptoms may include profound weakness of the hands, bowel or bladder dysfunction, and severe gait ataxia. Rarely there is loss of proximal muscle strength in the arms or legs.
Other
-
-
A history of violent trauma (for example, a road traffic accident) or a fall from a height or minor trauma in a person at risk of osteoporosis, for example, post–menopausal women. Consider possible fractures. Even minor trauma may result in fractures of the spine in people with osteoporosis.
-
A history of immunosuppression, tuberculosis, or intravenous drug abuse (consider spinal abscess, discitis, or osteomyelitis).
-
Other neurological signs and symptoms, such as altered cognitive state, weakness involving more than one myotome or loss of sensation involving more than one dermatome.
History or features of vascular disease, such as blackouts, dizziness, or a pulsatile mass in the neck.
Presence of congenital disorders which may rarely predispose to atlanto-axial subluxation (such as Down's syndrome), or lead to spinal or soft tissue abnormalities.
Malignancy, infection or inflammation
-
-
Excruciating pain, intractable night pain, increasing pain, exquisite tenderness over vertebral body, generalised neck stiffness
-
Fever, night sweats, unexplained weight loss
-
-
Skin erythema, wounds or exudate
-
Definition: Simple (or non-specific) neck pain is pain or discomfort in the neck and/or shoulder girdle with or without pain referred to the arms. In most cases no specific cause can be found. Non-specific neck pain usually relates to mechanical or postural factors, and the term excludes those where the cause is underlying fracture, malignancy or systemic pathology.