Cervical Spine Athletic Injuries: A Pain in the Neck

Industrial medicine and acute musculoskeletal rehabilitation. 2. Acute cervical spine and shoulder injuries in the industrial setting

This self-directed learning module highlights the underlying anatomy and biomechanics of the cervical spine and shoulder as a basis for developing a differential diagnosis of contributing pathology in an industrial injury. This includes components of the history, examination, and appropriate diagnostic testing that are necessary to develop an optimal rehabilitation plan. Treatment options are reviewed and include medications, therapy, selective injections, and return-to-work programs in the industrial setting.

OVERALL ARTICLE OBJECTIVES

(a) To be able to identify neck and shoulder pathology, (b) to effectively evaluate cervical spine and shoulder injuries, and (c) to rehabilitate acute cervical spine and shoulder injuries in the industrial setting.

The diagnosis and treatment of cervical radiculopathy

To provide a comprehensive review of the presentation, evaluation, differential diagnosis, treatment and return-to-play criteria which can be useful to the clinician caring for athletes with cervical radiculopathy. A review of the literature on cervical radiculopathy and sports injuries of the cervical spine was performed. This information was used in conjunction with the author's clinical experience to present a literature based approach to the diagnosis and treatment of cervical radiculopathy in athletic individuals. There was limited scientific literature on the evaluation and treatment of cervical radiculopathy in athletes. Many studies reported on the evaluation and treatment of the "burner" or "stinger" in the younger athlete which may represent a cervical radiculopathy in many of these cases. A nonoperative treatment plan using a logical step-wise approach is successful in the vast majority of these patients. Using the history and a detailed physical examination, along with imaging and other diagnostic studies when necessary, a proper diagnosis of cervical radiculopathy can be made. Once a discrete diagnosis is made, then a systematic approach to the treatment and rehabilitation can be implemented to optimize a safe return to competition.

Neck Pain

In brief Most nontraumatic conditions brief that produce neck pain can be managed by primary care physicians, with physical therapy to augment rehabilitation. One key role the physician can often play is to reassure the patient that the injury is not serious. After that, the goal of immediate treatment is to minimize pain and inflammation with nonsteroidal medication and icing. Other options can include brief bed rest, narcotic analgesics, a cervical collar, and, depending on the condition, corticosteroids, local injections, acetaminophen, and moist heat. Rehabilitation to recover lost function should address the entire kinetic chain and include an aerobic component. Return to play must be gradual. Some injured or aging patients may have to cut back on activity or cross-train to maintain an active lifestyle.