2) Myofascial pain syndrome - Neck pain spreading to the scapular region and the shoulder in levator scapulae MFPS, paraspinal neck pain spreading down to the upper posterior chest wall in multifidi MFPS, neck pain spreading along the paracervical region to the posterior chest wall upper scapular region in multifidi MFPS, neck pain at lower neck spreading up to the upper neck in splenius cervicis MFPS, lateral neck pain, ipsilateral head pain mainly at occiput, temporal, parietal regions, mandibular area of the face in trapezius MFPS, pain in the paraspinal region extending over an area from spineof scapula to the inferior angle of the scapula in trapezius MFPS. See notes under myofascial pain syndrome for diagnostic criteria and therapy.
3) Cervical Disc Prolapse – neck pain, central and bilateral, pain over the scapular region, pain radiating to the shoulder, upper arm, forearm, and chest, the pain made worse by laughing, sneezing, coughing, and straining, painful neck movements, neck muscle spasm, arm weakness
4) Cervical radiculopathy – neck pain, neck pain shooting down the arm, forearm, numbness, tingling shooting down the arms, forearm, hand, shoulder pain, elbow pain, forearm pain, pain shooting down the arm, paresthesiae shooting down the arm, increased pain with Valsalva maneuver, nerve tension maneuvers positive – i) turn the neck to the opposite side of the lesion, extend the arm at shoulder keeping the elbow extended. Grasp the patient’s hand palmar flex the wrist. Feeling the pain in the posterior shoulder suggests cervical radiculopathy, alternatively you can also dorsiflex the wrist, in this instance, numbness and tingling of the elbow and hand suggests cervical radiculopathy, ii) Keep the ipsilateral arm on top of the head, then look down and contralaterally – this will reduce pain iii) Keep the ipsilateral arm on top of the head and then rotate and bend the head to the ipsilateral side – this will increase pain iv) Spurling’s sign – rotate the head to the contralateral side and side flex the head towards painful arm – pain shooting down the arm signifies a positive test,
5) Whiplash injury – neck injury in an RTA – a sudden extension of the neck followed by flexion, pain, and symptoms tend to peak the day after the injursudden extension of the neck followed by flexion, pain, and symptoms tend to peak the day after the injury, unilateral or mostly bilateral neck pain hours to days after a minor RTA, may last weeks to months, natural history is RTA and whiplash injury, pain peaks the second day, pain and symptoms resolve over the next 3-5 days, patient back to work after a week, – Neck exercises (N), NSAIDs
6) Torticollis – acute onset neck pain usually on waking up in the morning, may last few days, painful neck movements, limitation of neck movements, Tx – Neck exercises (N) and NSAIDs,
7) Myofascial pain syndromes -
8) Cervical Syndrome of RSI – RSI criteria (N), repetitive shoulder movements, repetitive upper limb movements, particularly against gravity, all these require stability provided by neck and shoulder girdle muscles, pain in the neck with radiation into the arm, neck painful movements (3 at least out of 6), pain radiation into the arm on neck movements
9) Tension Neck Syndrome of RSI – RSI criteria (N), repetitive shoulder movements, repetitive upper limb movements, particularly against gravity, all these require stability provided by neck and shoulder girdle muscles, neck pain, neck stiffness, headache radiating from the neck to the forehead, at least 2 tender spots in the neck muscles (cervical and trapezius muscles), palpable nodules in the neck muscles,