12 month prevelence of those with neck disability
1.7-11.5%
annual rate that neck pain resolves on its own, persist and get better and how mmuch get worse
1/3 for each
worse- almost 10%
what are the most common structures that create pain in spine (3)
- facet jts
- Muscles
- Disks
non modifiable risk factors of neck pain + modifiable
Age
Gender
Genetics
Smoking
Physical activity participation
what % of people will have neck pain reoccurence in 1-5y
50-85% of people
positive prognostic factors
younger age, optimism, self assurance, less need to socialize
3 classification of neck pain + associated disorders
1- no signs/symptoms suggestive of major structural pathology
- -no signs/symptoms suggestive of major structural pathology, major interferience w adls
- No signs/symptoms of major structural pathology, prescence of neuro signs
recoemandations for recent and persistant grades 1-3 neck pain
recent- pt education w ex and manip or mobs
persistant- education w ex and manip or mobs and massage, low level laser and NSAIDs
when do u have to update informd consent
2 years since last signage
pt has new conditions
change tx
2 most frequent serious complications of SMT
- vertebrobasilar accidents
2. Cauda equina syndrome
what are the two main reasons MDs avoid reffering to chiros
- percievded lack of scientific evidence
2. Impression that it is pot dangerous
risk of stroke after cervical manipulation
1 in 1.5 mil
Absolute contraindications to SMT
- Acute Arthropathies (rematoid arthritis, ankylosing)
- Acute Fx
- Signs of lig rupture/instability
- Metasisis
- Infections of bone
- Acute myelopathy
- cauda equina
Relative contraindications to SMT
- spondylothesis
- Post surgical jts
- Acute soft tissue inj
- osteoperosis
- benign bone tumor
- anerusym
- VBI
Probable contraindications to SMT
- age > 50
- hx of sig trauma
- fever >100
- prolonged corticosteroid use
- hx of cancer
some other possible contraindications to cervical SMT
- ethlers danlos syndrome
- Joint hypermobility
- TIAs
- Prior strokes
- high lvls of homocysteine
