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= Arthritis of the neck  Degenerative condition  Affects the vertebral bodies, the intervertebral discs,the facet joints and eventually the contents.

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Presentation on theme: "= Arthritis of the neck  Degenerative condition  Affects the vertebral bodies, the intervertebral discs,the facet joints and eventually the contents."— Presentation transcript:

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2 = Arthritis of the neck  Degenerative condition  Affects the vertebral bodies, the intervertebral discs,the facet joints and eventually the contents of the spinal canal  Involves the degeneration of cartilage and the formation of osteophytes (spurs)  Results in pain and stiffness  Worsens with age

3 Denegation that occurs naturally with age Occurs in the facet joints and the intervertebral discs Discs lose water and weaken Movement segment

4 Increase in mechanical stress at cartilage end plates with an increase in pressure at the facet joints Cartilage therefore gets worn away and results in bone on bone contact

5 Body response is the formation of osteophytes=spurs Supports the decaying vertebrae Creates a narrow space for nerves to pass

6 Disc:  Decreased elasticity of annulus fibrosis  Loss of fluid in nucleus pulposes Therefore unable to withstand compression forces and bulges decrease in disc height  Formation of osteophytes: ◦ Forms where tension is the greatest ◦ Forms at the edges of the vertebrae

7 Facet joints  In closer contact due to decreased height of the disc  Stretching of the capsule due to inferior facet moving down on the superior facet  Facet joints move into a position of extension and therefore experience an increase of stress during normal daily activities

8 Vertebral body:  Development of sclerosis= hardening of tissue/structures Intervertebral foramen:  Decreased due to the formation of osteophytes and loss of disc height Spinous processes:  Formation of a false joint due to the spinous processes coming into contact with one another

9 Collapse of intervertebral disc and joint space

10 Three stages occur during degeneration 1. Dysfunction ◦ Dysfunction of the trunk fascia, muscles, ligaments, capsule, neural structures and z- joints. ◦ Results from mechanical stress, injuries and overuse injuries 2.Instability ◦ Disc mal-alignment and degeneration due to a loss of protection from these structures ◦ Results in segmental stability

11 3. Stabilisation period ◦ This is the body's effort towards healing

12  Age –especially above 60 years  Family history of neck pain  Overweight  Sports  Occupations involving excessive neck motion/overhead working  Previous neck injury/trauma  Ruptured/slipped disk

13 Spur formation with narrowing of the disc space

14  Can develop ◦ Slowly ◦ Sudden onset  Headaches  Neck stiffness  Weakness ◦ Difficulty with lifting arm or squeezing hand  Abnormal sensations or numbness ◦ Shoulder/arms/legs

15  Pain ◦ Mild ◦ Severe Location: behind neck, m.trapezius, upper arm, forearm and fingers Aggravated by: ◦ Sudden movements ◦ Stretching at end range Worse in the morning

16  Loss of balance  Muscle spasms of neck and shoulders  Grinding/popping noise with movement  Reduced reflexes  Difficulty rotating head in all directions

17 Conservative:  Physiotherapy ◦ Strengthening of neck muscles ◦ Stretching ◦ Neck traction ◦ Posture therapy ◦ Ice/hot packs ◦ Care of the neck and advice ◦ Passive mobilisations

18  Medication ◦ NSAIDS (aspirin,ibuprofen) ◦ Muscle relaxants ◦ Steroid injections ◦ Anti convulsants/antidepressants ◦ Narcotics/opiods (not on a daily basis)  Soft collars NB ! Short term only! ◦ Limits neck motion

19  Surgery (foraminotomy,laminectomy, spinal fusion) ◦ Uncommon ◦ If conservative management fails ◦ Only for severe pain ◦ Neurological symptoms

20 Long lasting Cervical Radicular Pain Managed With Surgery, Physiotherapy, or a Cervical Collar: A Prospective,Randomized Study.  Compared the effect of surgery, physiotherapy and a cervical collar on cervical radicular pain as a result of cervical spondylosis  Included 81 patients who have experienced cervicobrachial pain for at least 3 months

21  The pain must be a direct result from a root compression with or without a bulging disc  Patients were randomly allocated to each treatment method  It was concluded at the end of a 12 month evaluation that either method was a successful as the next  This implied that the condition is dominant in its degeneration

22 Persson,L.C.,Carlsson,C.,Carlsson,J.1997.Long- Lasting Cervical Radicular Pain Managed With Surgery,Physiotherapy, or a Cervical Collar : A Prospective,Randomized Study. Sweden : Lippincott, Williams & Wilkins. Fox.M.L.2009.American Academy of Orthopaedic Surgeons. Retrieved on 12 May 2012.

23 Vorvick,L.J.,Benjamin,C and Zieve,D.2011.National Center for Biotechnology Information:US National Library of Medicine Retrieved on 12 May Barnes,R.2011.NEUROMUSCULAR-SKELETAL REHABILITATION DICTATE.(Unpublished dictate.) University of the Free State, Free State.


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