Neck Pain: Discomfort or more intense forms of pain that are localized to the cervical region. This term generally refers to pain in the posterior or lateral regions of the neck.Neck: The part of a human or animal body connecting the HEAD to the rest of the body.Pain: An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS.Head and Neck Neoplasms: Soft tissue tumors or cancer arising from the mucosal surfaces of the LIP; oral cavity; PHARYNX; LARYNX; and cervical esophagus. Other sites included are the NOSE and PARANASAL SINUSES; SALIVARY GLANDS; THYROID GLAND and PARATHYROID GLANDS; and MELANOMA and non-melanoma skin cancers of the head and neck. (from Holland et al., Cancer Medicine, 4th ed, p1651)Chronic Pain: Aching sensation that persists for more than a few months. It may or may not be associated with trauma or disease, and may persist after the initial injury has healed. Its localization, character, and timing are more vague than with acute pain.Whiplash Injuries: Hyperextension injury to the neck, often the result of being struck from behind by a fast-moving vehicle, in an automobile accident. (From Segen, The Dictionary of Modern Medicine, 1992)Back Pain: Acute or chronic pain located in the posterior regions of the THORAX; LUMBOSACRAL REGION; or the adjacent regions.Pain Measurement: Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies.Pain Management: A form of therapy that employs a coordinated and interdisciplinary approach for easing the suffering and improving the quality of life of those experiencing pain.Neck Muscles: The neck muscles consist of the platysma, splenius cervicis, sternocleidomastoid(eus), longus colli, the anterior, medius, and posterior scalenes, digastric(us), stylohyoid(eus), mylohyoid(eus), geniohyoid(eus), sternohyoid(eus), omohyoid(eus), sternothyroid(eus), and thyrohyoid(eus).Cervical Vertebrae: The first seven VERTEBRAE of the SPINAL COLUMN, which correspond to the VERTEBRAE of the NECK.Neck Injuries: General or unspecified injuries to the neck. It includes injuries to the skin, muscles, and other soft tissues of the neck.Low Back Pain: Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous SPRAINS AND STRAINS; INTERVERTEBRAL DISK DISPLACEMENT; and other conditions.Pain Threshold: Amount of stimulation required before the sensation of pain is experienced.Pain, Postoperative: Pain during the period after surgery.Acute Pain: Intensely discomforting, distressful, or agonizing sensation associated with trauma or disease, with well-defined location, character, and timing.Musculoskeletal Manipulations: Various manipulations of body tissues, muscles and bones by hands or equipment to improve health and circulation, relieve fatigue, promote healing.Shoulder Pain: Unilateral or bilateral pain of the shoulder. It is often caused by physical activities such as work or sports participation, but may also be pathologic in origin.Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region.Pain, Intractable: Persistent pain that is refractory to some or all forms of treatment.Manipulation, Spinal: Adjustment and manipulation of the vertebral column.Disability Evaluation: Determination of the degree of a physical, mental, or emotional handicap. The diagnosis is applied to legal qualification for benefits and income under disability insurance and to eligibility for Social Security and workmen's compensation benefits.Pelvic Pain: Pain in the pelvic region of genital and non-genital origin and of organic or psychogenic etiology. Frequent causes of pain are distension or contraction of hollow viscera, rapid stretching of the capsule of a solid organ, chemical irritation, tissue ischemia, and neuritis secondary to inflammatory, neoplastic, or fibrotic processes in adjacent organs. (Kase, Weingold & Gershenson: Principles and Practice of Clinical Gynecology, 2d ed, pp479-508)Pain Perception: The process by which PAIN is recognized and interpreted by the brain.Facial Pain: Pain in the facial region including orofacial pain and craniofacial pain. Associated conditions include local inflammatory and neoplastic disorders and neuralgic syndromes involving the trigeminal, facial, and glossopharyngeal nerves. Conditions which feature recurrent or persistent facial pain as the primary manifestation of disease are referred to as FACIAL PAIN SYNDROMES.Chronic Disease: Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)Pain, Referred: A type of pain that is perceived in an area away from the site where the pain arises, such as facial pain caused by lesion of the VAGUS NERVE, or throat problem generating referred pain in the ear.Musculoskeletal Pain: Discomfort stemming from muscles, LIGAMENTS, tendons, and bones.Physical Therapy Modalities: Therapeutic modalities frequently used in PHYSICAL THERAPY SPECIALTY by PHYSICAL THERAPISTS or physiotherapists to promote, maintain, or restore the physical and physiological well-being of an individual.Acupuncture Analgesia: Analgesia produced by the insertion of ACUPUNCTURE needles at certain ACUPUNCTURE POINTS on the body. This activates small myelinated nerve fibers in the muscle which transmit impulses to the spinal cord and then activate three centers - the spinal cord, midbrain and pituitary/hypothalamus - to produce analgesia.Femoral Neck Fractures: Fractures of the short, constricted portion of the thigh bone between the femur head and the trochanters. It excludes intertrochanteric fractures which are HIP FRACTURES.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Zygapophyseal Joint: The joint that occurs between facets of the interior and superior articular processes of adjacent VERTEBRAE.Traction: The pull on a limb or a part thereof. Skin traction (indirect traction) is applied by using a bandage to pull on the skin and fascia where light traction is required. Skeletal traction (direct traction), however, uses pins or wires inserted through bone and is attached to weights, pulleys, and ropes. (From Blauvelt & Nelson, A Manual of Orthopaedic Terminology, 5th ed)Range of Motion, Articular: The distance and direction to which a bone joint can be extended. Range of motion is a function of the condition of the joints, muscles, and connective tissues involved. Joint flexibility can be improved through appropriate MUSCLE STRETCHING EXERCISES.Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Headache: The symptom of PAIN in the cranial region. It may be an isolated benign occurrence or manifestation of a wide variety of HEADACHE DISORDERS.Spondylosis: A degenerative spinal disease that can involve any part of the VERTEBRA, the INTERVERTEBRAL DISK, and the surrounding soft tissue.Saskatchewan: A province of Canada, lying between the provinces of Alberta and Manitoba. Its capital is Regina. It is entirely a plains region with prairie in the south and wooded country with many lakes and swamps in the north. The name was taken from the Saskatchewan River from the Cree name Kisiskatchewani Sipi, meaning rapid-flowing river. (From Webster's New Geographical Dictionary, 1988, p1083 & Room, Brewer's Dictionary of Names, 1992, p486)Muscle Stretching Exercises: Exercises that stretch the muscle fibers with the aim to increase muscle-tendon FLEXIBILITY, improve RANGE OF MOTION or musculoskeletal function, and prevent injuries. There are various types of stretching techniques including active, passive (relaxed), static, dynamic (gentle), ballistic (forced), isometric, and others.Analgesics: Compounds capable of relieving pain without the loss of CONSCIOUSNESS.Massage: The systematic and methodical manipulations of body tissues best performed with the hands for the purpose of affecting the nervous and muscular systems and the general circulation.Occupational Diseases: Diseases caused by factors involved in one's employment.Exercise Therapy: A regimen or plan of physical activities designed and prescribed for specific therapeutic goals. Its purpose is to restore normal musculoskeletal function or to reduce pain caused by diseases or injuries.Computer Terminals: Input/output devices designed to receive data in an environment associated with the job to be performed, and capable of transmitting entries to, and obtaining output from, the system of which it is a part. (Computer Dictionary, 4th ed.)Acupuncture Therapy: Treatment of disease by inserting needles along specific pathways or meridians. The placement varies with the disease being treated. It is sometimes used in conjunction with heat, moxibustion, acupressure, or electric stimulation.Radiculopathy: Disease involving a spinal nerve root (see SPINAL NERVE ROOTS) which may result from compression related to INTERVERTEBRAL DISK DISPLACEMENT; SPINAL CORD INJURIES; SPINAL DISEASES; and other conditions. Clinical manifestations include radicular pain, weakness, and sensory loss referable to structures innervated by the involved nerve root.Illness Behavior: Coordinate set of non-specific behavioral responses to non-psychiatric illness. These may include loss of APPETITE or LIBIDO; disinterest in ACTIVITIES OF DAILY LIVING; or withdrawal from social interaction.Spinal DiseasesAccidents, Traffic: Accidents on streets, roads, and highways involving drivers, passengers, pedestrians, or vehicles. Traffic accidents refer to AUTOMOBILES (passenger cars, buses, and trucks), BICYCLING, and MOTORCYCLES but not OFF-ROAD MOTOR VEHICLES; RAILROADS nor snowmobiles.Atlanto-Axial Joint: The joint involving the CERVICAL ATLAS and axis bones.Musculoskeletal Diseases: Diseases of the muscles and their associated ligaments and other connective tissue and of the bones and cartilage viewed collectively.Posture: The position or attitude of the body.Carcinoma, Squamous Cell: A carcinoma derived from stratified SQUAMOUS EPITHELIAL CELLS. It may also occur in sites where glandular or columnar epithelium is normally present. (From Stedman, 25th ed)Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Analgesics, Opioid: Compounds with activity like OPIATE ALKALOIDS, acting at OPIOID RECEPTORS. Properties include induction of ANALGESIA or NARCOSIS.Psychology: The science dealing with the study of mental processes and behavior in man and animals.Post-Traumatic Headache: Secondary headache attributed to TRAUMA of the HEAD and/or the NECK.Human Engineering: The science of designing, building or equipping mechanical devices or artificial environments to the anthropometric, physiological, or psychological requirements of the people who will use them.Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve.Nociceptive Pain: Dull or sharp aching pain caused by stimulated NOCICEPTORS due to tissue injury, inflammation or diseases. It can be divided into somatic or tissue pain and VISCERAL PAIN.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Facial Neuralgia: Neuralgic syndromes which feature chronic or recurrent FACIAL PAIN as the primary manifestation of disease. Disorders of the trigeminal and facial nerves are frequently associated with these conditions.Chiropractic: An occupational discipline founded by D.D. Palmer in the 1890's based on the relationship of the spine to health and disease.Injections, Epidural: The injection of drugs, most often analgesics, into the spinal canal without puncturing the dura mater.Intervertebral Disc Displacement: An INTERVERTEBRAL DISC in which the nucleus pulposus has protruded through surrounding fibrocartilage. This occurs most frequently in the lower lumbar region.Manipulation, Chiropractic: Procedures used by chiropractors to treat neuromusculoskeletal complaints.Hyperalgesia: An increased sensation of pain or discomfort produced by mimimally noxious stimuli due to damage to soft tissue containing NOCICEPTORS or injury to a peripheral nerve.Vertebral Artery Dissection: Splitting of the vessel wall in the VERTEBRAL ARTERY. Interstitial hemorrhage into the media of the vessel wall can lead to occlusion of the vertebral artery, aneurysm formation, or THROMBOEMBOLISM. Vertebral artery dissection is often associated with TRAUMA and injuries to the head-neck region but can occur spontaneously.Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.Anesthetics, Local: Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.Spinal Fusion: Operative immobilization or ankylosis of two or more vertebrae by fusion of the vertebral bodies with a short bone graft or often with diskectomy or laminectomy. (From Blauvelt & Nelson, A Manual of Orthopaedic Terminology, 5th ed, p236; Dorland, 28th ed)Odontoid Process: The toothlike process on the upper surface of the axis, which articulates with the CERVICAL ATLAS above.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Intervertebral Disc Degeneration: Degenerative changes in the INTERVERTEBRAL DISC due to aging or structural damage, especially to the vertebral end-plates.Shoulder: Part of the body in humans and primates where the arms connect to the trunk. The shoulder has five joints; ACROMIOCLAVICULAR joint, CORACOCLAVICULAR joint, GLENOHUMERAL joint, scapulathoracic joint, and STERNOCLAVICULAR joint.Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness.Myofascial Pain Syndromes: Muscular pain in numerous body regions that can be reproduced by pressure on TRIGGER POINTS, localized hardenings in skeletal muscle tissue. Pain is referred to a location distant from the trigger points. A prime example is the TEMPOROMANDIBULAR JOINT DYSFUNCTION SYNDROME.Nerve Block: Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain.
Avijit Lahiri: Avijit Lahiri is a researcher in cardiology[http://www.journals.Cancer pain: Pain in cancer may arise from a tumor compressing or infiltrating nearby body parts; from treatments and diagnostic procedures; or from skin, nerve and other changes caused by a hormone imbalance or immune response. Most chronic (long-lasting) pain is caused by the illness and most acute (short-term) pain is caused by treatment or diagnostic procedures.Head and Neck Cancer Alliance: The Head and Neck Cancer Alliance (HNCA) is a non-profit organization that works with health professionals and organizations, celebrities and survivors to enhance the overall effort in prevention, treatment, and detection of cancers of the head and neck region.Chronic painPain scale: A pain scale measures a patient's pain intensity or other features. Pain scales are based on self-report, observational (behavioral), or physiological data.Sternohyoid muscle: The sternohyoid muscle is a thin, narrow muscle attaching the hyoid bone to the sternum, one of the paired strap muscles of the infrahyoid muscles serving to depress the hyoid bone. It is innervated by the ansa cervicalis.Cervical fractureLow back painHypoalgesia: Hypoalgesia or hypalgesia denotes a decreased sensitivity to painful stimuli.Spinal manipulation: Spinal manipulation is a therapeutic intervention performed on spinal articulations which are synovial joints. These articulations in the spine that are amenable to spinal manipulative therapy include the z-joints, the atlanto-occipital, atlanto-axial, lumbosacral, sacroiliac, costotransverse and costovertebral joints.International Disability and Development Consortium: The International Disability and Development Consortium (IDDC) is a global consortium of disability and development related organisations. The aim of IDDC is to promote inclusive development internationally, with a special focus on promoting human rights for all disabled people living in economically poor communities in lower and middle-income countries.Pelvic congestion syndrome: Pelvic congestion syndrome (also known as pelvic vein incompetence) is a chronic medical condition in women caused by varicose veins in the lower abdomen. The condition causes chronic pain, often manifesting as a constant dull ache, which can be aggravated by standing.Thermal grill illusion: The thermal grill illusion is a sensory illusion originally demonstrated in 1896 by the Swedish physician Torsten Thunberg. The illusion is created by an interlaced grill of warm (e.Non-communicable disease: Non-communicable disease (NCD) is a medical condition or disease that is non-infectious or non-transmissible. NCDs can refer to chronic diseases which last for long periods of time and progress slowly.Journal of Musculoskeletal Pain: The Journal of Musculoskeletal Pain is a quarterly Peer review-peer-reviewed medical journal covering research on chronic muscle and bone pain, including fibromyalgia, myofascial pain, and other types of musculoskeletal pain. It is published by Informa Healthcare.Select MedicalFacet joint injection: Facet joint injections are used to alleviate symptoms of facet joint syndrome.Facet Joint SyndromeTraction substation: A traction substation or traction current converter plant is an electrical substation that converts electric power from the form provided by the electrical power industry for public utility service to an appropriate voltage, current type and frequency to supply railways, trams (streetcars) or trolleybuses with traction current.Closed-ended question: A closed-ended question is a question format that limits respondents with a list of answer choices from which they must choose to answer the question.Dillman D.International Classification of Headache Disorders: The International Classification of Headache Disorders (ICHD) is a detailed hierarchical classification of all headache-related disorders published by the International Headache Society. It is considered the official classification of headaches by the World Health Organization, and, in 1992, was incorporated into the 10th edition of their International Classification of Diseases (ICD-10).SpondylosisRobinhood, Saskatchewan: Robinhood is a hamlet in Medstead Rural Municipality No. 497, Saskatchewan, Canada.Compound analgesic: Compound analgesics are those with multiple active ingredients; they include many of the stronger prescription analgesics.Hydro massageExercise prescription software: Exercise prescription software is a branch of computer software designed to aid in the construction of exercise programmes or regimes for patients who require some kind of ongoing rehabilitation.AcupunctureRadiculopathySickness behavior: [Ancher 001.jpg|thumb|350px|right|Ancher, Michael], "The Sick Girl", 1882, [[Statens Museum for Kunst.Cervical spine disorder: Cervical Spine Disorders are illnesses that are relatively detrimental to ones physical health. These ailments exist in the cervical spine which is made up of the upper first seven vertebrae, encasing and shielding the Spinal cord.ISO 39001: The ISO 39001 "Road Traffic Safety Management" is an ISO standard for a management system (similar to ISO 9000) for road traffic safety. The implementation of the standard is supposed to put the organizations, that provide the system "road traffic", into the position to improve the traffic safety and to reduce by that the number of persons killed or severely injured in road traffic.Riding-like sittingSquamous-cell carcinomaOpioid: Opioids are substances that act on the nervous system in a similar way to opiates such as morphine and codeine. In a medical context the term usually indicates medications that are artificially made rather than extracted from opium.NEFERTHuman factors and ergonomics: Human factors and ergonomics (HF&E), also known as comfort design, functional design, and user-friendly systems,Ergonomics in Thesaurus.com is the practice of designing products, systems or processes to take proper account of the interaction between them and the people who use them.Neuropathic painChiropractic in Canada: Chiropractic in Canada is licensed at the provincial and territorial level. Council on Chiropractic Education of Canada accredits educational programs.Lumbar disc disease: Lumbar disc disease is the drying out of the spongy interior matrix of an intervertebral disc in the spine. Many physicians and patients use the term lumbar disc disease to encompass several different causes of back pain or sciatica.Opioid-induced hyperalgesia: Opioid-induced hyperalgesia or opioid-induced abnormal pain sensitivity, also called paradoxical hyperalgesia is a phenomenon associated with the long term use of opioids such as morphine, hydrocodone, oxycodone, and methadone. Over time, individuals taking opioids can develop an increasing sensitivity to noxious stimuli, even evolving a painful response to previously non-noxious stimuli (allodynia).Local anesthetic: Local anesthetic (LA) is a medication that causes reversible absence of pain sensation, although other senses are often affected as well. Also, when it is used on specific nerve pathways (local anesthetic nerve block), paralysis (loss of muscle power) can be achieved as well.Interbody fusion cage: An interbody fusion cage (colloquially known as a "spine cage") is a prosthesis used in spinal fusion procedures to maintain foraminal height and decompression. They are cylindrical or square-shaped devices, and usually threaded.Temporal analysis of products: Temporal Analysis of Products (TAP), (TAP-2), (TAP-3) is an experimental technique for studyingDegenerative disc diseaseGyromancy: Gyromancy is a method of divination in which a person spins around inside or walks the circumference of a circle drawn on the ground, the perimeter of which is marked with the letters of an alphabet. The divination is inferred from the letter at the position where the person either stumbles or falls across the circle’s edge.Dry needling: Dry needling (Myofascial Trigger Point Dry Needlinghttp://www.ncbi.Nerve block
(1/707) A chiropractic service arrangement for musculoskeletal complaints in industry: a pilot study.
Chiropractic services are commonly used by workers with musculoskeletal problems, especially low back and neck complaints. Research into the effectiveness and cost-effectiveness of this approach is, however, difficult to design without prior pilot studies. This study followed 32 workers with these complaints attending one such service and used five measures of outcome over a 6-month period. These measured pain (VAS), disability (FLP), quality of life (SF-36), perceived benefit and satisfaction with care. Additionally, sickness costs to the companies were recorded over two years encompassing the study period. Treatment utilization was also monitored. Over half the population were chronic sufferers. The effect sizes were large for pain and for seven out of eight dimensions of the SF-36 questionnaire at 6-month follow-up, although not for disability (FLP). High levels of satisfaction and perceived improvement were reported and sickness costs to the companies fell. However, the sample size in this pilot study was small and did not include controls. We would, therefore, recommend a full cost-effectiveness study incorporating a randomized trial in this area. (+info)
(2/707) Pain after whiplash: a prospective controlled inception cohort study.
OBJECTIVES: In Lithuania, there is little awareness of the notion that chronic symptoms may result from rear end collisions via the so-called whiplash injury. After most such collisions no contact with the health service is established. An opportunity therefore exists to study post-traumatic pain without the confounding factors present in western societies. METHODS: In a prospective, controlled inception cohort study, 210 victims of a rear end collision were consecutively identified from the daily records of the Kaunas traffic police. Neck pain and headache were evaluated by mailed questionnaires shortly after the accident, after 2 months, and after 1 year. As controls, 210 sex and age matched subjects were randomly taken from the population register of the same geographical area and evaluated for the same symptoms immediately after their identification and after 1 year. RESULTS: Initial pain was reported by 47% of accident victims; 10% had neck pain alone, 18% had neck pain together with headache, and 19% had headache alone. The median duration of the initial neck pain was 3 days and maximal duration 17 days. The median duration of headache was 4.5 hours and the maximum duration was 20 days. After 1 year, there were no significant differences between the accident victims and the control group concerning frequency and intensity of these symptoms. CONCLUSIONS: In a country were there is no preconceived notion of chronic pain arising from rear end collisions, and thus no fear of long term disability, and usually no involvement of the therapeutic community, insurance companies, or litigation, symptoms after an acute whiplash injury are self limiting, brief, and do not seem to evolve to the so-called late whiplash syndrome. (+info)
(3/707) Epidurography and therapeutic epidural injections: technical considerations and experience with 5334 cases.
BACKGROUND AND PURPOSE: Even in experienced hands, blind epidural steroid injections result in inaccurate needle placement in up to 30% of cases. The use of fluoroscopy and radiologic contrast material provides confirmation of accurate needle placement within the epidural space. We describe our technique and experience with contrast epidurography and therapeutic epidural steroid injections, and review the frequency of systemic and neurologic complications. METHODS: Epidural steroid injections were performed in 5489 consecutive outpatients over a period of 5 1/2 years by three procedural neuroradiologists. In 155 cases (2.8%), the injections were done without contrast material owing to either confirmed or suspected allergy. The remaining 5334 injections were performed after epidurography through the same needle. Patients and referring clinicians were instructed to contact us first regarding complications or any problem potentially related to the injection. In addition, the referring clinicians' offices were instructed to contact us regarding any conceivable procedure-related complications. RESULTS: Only 10 patients in the entire series required either oral (n = 5) or intravenous (n = 5) sedation. Four complications (0.07%) required either transport to an emergency room (n = 2) or hospitalization (n = 2). None of the complications required surgical intervention, and all were self-limited with regard to symptoms and imaging manifestations. Fluoroscopic needle placement and epidurography provided visual confirmation of accurate needle placement, distribution of the injectate, and depiction of epidural space disease. CONCLUSION: Epidurography in conjunction with epidural steroid injections provides for safe and accurate therapeutic injection and is associated with an exceedingly low frequency of untoward sequelae. It can be performed safely on an outpatient basis and does not require sedation or special monitoring. (+info)
(4/707) Risk factors for neck and upper limb disorders: results from 24 years of follow up.
OBJECTIVES: To investigate associations between different potential risk factors, related and not related to work, and disorders of the neck and upper extremities occurring up to 24 years later. METHODS: The study comprised 252 women and 232 men, Swedish citizens, 42-59 years of age and in a broad range of occupations. Information about potential risk factors was available from a former study conducted in 1969. Data on disorders of the neck, shoulder, and hand-wrist disorders were obtained retrospectively for the period 1970-93. RESULTS: Risk factors were found to differ between the sexes. Among women over-time work, high mental workload, and unsatisfactory leisure time were associated with disorders in the neck-shoulder region. Interaction was found between high mental workload and unsatisfactory leisure time. Neck symptoms earlier in life were associated with recurrent disorders. Hand and wrist disorders were associated mainly with physical demands at work. Among men blue collar work and a simultaneous presence of high mental workload and additional domestic workload predicted disorders in the neck-shoulder region. CONCLUSIONS: Factors related and not related to work were associated with disorders of the neck, shoulders, and hands and wrist up to 24 years later in life. These included factors related to working hours which previously have not been noted in this context. Interactions between risk factors both related and not related to work were commonly found. (+info)
(5/707) A systematic review of randomized controlled trials of acupuncture for neck pain.
OBJECTIVE: To establish whether there is evidence for or against the efficacy of acupuncture in the treatment of neck pain. METHODS: A systematic literature review was undertaken of studies that compared needle or laser acupuncture with a control procedure for the treatment of neck pain. Two reviewers independently extracted data concerning study methods, quality and outcome. RESULTS: Overall, the outcomes of 14 randomized controlled trials were equally balanced between positive and negative. Acupuncture was superior to waiting-list in one study, and either equal or superior to physiotherapy in three studies. Needle acupuncture was not superior to indistinguishable sham control in four out of five studies. Of the eight high-quality trials, five were negative. CONCLUSIONS: In conclusion, the hypothesis that acupuncture is efficacious in the treatment of neck pain is not based on the available evidence from sound clinical trials. Further studies are justified. (+info)
(6/707) Fish processing work: the impact of two sex dependent exposure profiles on musculoskeletal health.
OBJECTIVES: To evaluate the impact of work tasks, physical exposure, and psychosocial factors on the risk of musculoskeletal disorders in men and women, in a defined industrial setting. METHODS: 116 male and 206 female fish industry workers were compared with 129 men and 208 women with more varied work. Physical and psychosocial work load as well as musculoskeletal complaints were recorded by a questionnaire. A physical examination was performed and an observation method was used for work evaluation. 196 male and 322 female former fish processing workers received a postal questionnaire. RESULTS: The women workers in the fish industry had worse working conditions than the men for repetitiveness, constrained neck postures, and psychosocial work environment. They also had higher prevalences of complaints of the neck and shoulder (prevalence odds ratio (POR) 1.9; 95% confidence interval (95% CI) 1.1 to 3.2), neck and shoulder and elbow and hand complaints (POR 2.9; 95% CI 1.8 to 4.7 and POR 2.8; 95% CI 1.6 to 4.7, respectively). The women more often than the men left the industry because of neck and upper limb complaints. Also, women in other work had a higher prevalence of complaints of the neck and shoulder (POR 2.3; 95% CI 1.1 to 5.1) than the men. The men in the fish processing industry had a higher prevalence of complaints of the neck and shoulder than the men in other work (POR 3.6; 95% CI 1.6 to 8.0). This difference was not shown up by the questionnaire. CONCLUSIONS: Despite superficially similar work, there were clear sex differences in physical exposure and psychosocial work environment. Work in the fish processing industry was associated with a high risk of neck and upper limb disorders in women, which was probably mainly due to their extremely repetitive work tasks; the corresponding men had less repetitive work and less disorders. Also, a healthy worker effect on neck and upper limb disorders was found. The advantage of a physical examination compared with a questionnaire is clearly shown. (+info)
(7/707) Repeatability and validity of an upper limb and neck discomfort questionnaire: the utility of the standardized Nordic questionnaire.
The repeatability and validity of a questionnaire for upper limb and neck complaints were assessed in a population of 105 hospital outpatients with a range of upper limb and neck disorders (including cervical spondylosis, adhesive capsulitis, lateral epicondylitis, carpal tunnel syndrome and Raynaud's phenomenon). Subjects were asked to complete a modified Nordic-style upper limb and neck discomfort questionnaire on two occasions closely spaced in time. The repeatability of their responses was assessed by calculating a kappa coefficient (kappa), and the sensitivity and specificity of component items in the questionnaire were determined for specific diagnostic categories of upper limb and neck disorder. Symptom reports for pain in the upper limb and neck, pain interfering with physical activities, neurological symptoms and blanching were all found to be highly repeatable (kappa = 0.63-0.90). A number of regional pain reports proved to be very sensitive in relation to specific upper limb disorders, but, with the exception of reported finger blanching in patients with Raynaud's phenomenon, none proved to have a good specificity (range = 0.33-0.38). We conclude that a modified Nordic-style questionnaire is repeatable and sensitive, and is likely to have a high utility in screening and surveillance. However a complementary examination schedule of adequate specificity and repeatability is essential to establish a clinical diagnosis. (+info)
(8/707) Physical risk factors for neck pain.
To identify physical risk factors for neck pain, a systematic review of the literature was carried out. Based on methodological quality and study design, 4 levels of evidence were defined to establish the strength of evidence for the relationship between risk factors and neck pain. Altogether, 22 cross-sectional studies, 2 prospective cohort studies, and 1 case-referent study were eligible for determining the level of evidence. The results showed some evidence for a positive relationship between neck pain and the duration of sitting and twisting or bending of the trunk. A sensitivity analysis was carried out excluding 3 items of the quality list, the importance of which seemed doubtful. On the basis of this sensitivity analysis, it was concluded that there is some evidence for a positive relationship between neck pain and the following work-related risk factors: neck flexion, arm force, arm posture, duration of sitting, twisting or bending of the trunk, hand-arm vibration, and workplace design. (+info)