Sections View Full Chapter Figures Tables Videos Full Chapter Figures Tables Videos Supplementary Content ++ Simple neck painNeck sprain/strainMechanical neck pain ++ 729.1 Myalgia and myositis unspecified ++ M60.9 Myositis, unspecifiedM79.1 Myalgia ++ 4D: Impaired joint mobility, motor function, muscle performance, and range of motion associated with connective tissue dysfunction1 ++ Description ++ Neck pain from unknown causeNo underlying disease or specific disorderUsually acuteChronic, persistent, deep aching pains in muscle, non-articular in originUsually caused by sudden overload, overstretching, repetitive/sustained muscle activitiesPain associated with activities, generally relieved with restCan be in localized area affecting any muscle or fascia ++ Essentials of Diagnosis ++ Diagnosis made by clinical examination (generally palpation) with no medical diagnostic tests availableDifferentiated from fibromyalgia, as it can occur in a single area; fibromyalgia occurs in multiple locations, has specific tender points ++ General Considerations ++ Very common, affects most people in their lifetimesLatent trigger points are palpable, taut bands not tender to palpation, but may be converted into active trigger point ++ Demographics ++ In the U.S.: 14.4% of general population suffers from chronic musculoskeletal pain421% to 93% of patients reporting regional pain have myofascial pain225% to 54% of asymptomatic individuals have latent trigger points2No racial differences in incidence of myofascial pain have been describedMyofascial pain affects men and women equallyLikelihood of developing active trigger points increases with age and activity levelSedentary individuals more prone to developing active trigger points than individuals who exercise vigorously on a daily basis ++ Signs and Symptoms ++ Muscle stiffnessHeadachesVertigoParesthesiasReferred painJoint stiffnessLimited range of motion (ROM)Acute painPain with palpation of the trigger pointDifficulty sleepingWeakness without atrophy may be seen when performing manual muscle testing ++ Functional Implications ++ Pain with standing, ambulation, ADLsLimited range of motionWeakness ++ Possible Contributing Causes ++ Improper postureEmotional/psychological stressAnxietyBehaviorTraumatic eventsImproper lifting, poor biomechanicsLack of activity, immobility (cast)Repetitive stressOverusePoor muscular or ligamentous supportObesityInflammatory conditions affecting ligaments, muscles, tendons ++ Differential Diagnosis ++ Herniated discFibromyalgiaRheumatoid arthritisComplex regional pain syndromeRadiculopathyLigamentous sprainMuscle strainPeripheral nerve impairmentThoracic outlet syndromeShoulder pathology with radiating pain patternSpinal tumorCarpal tunnel syndromeDegenerative disk diseaseArnold Chiari malformation ++ Imaging ++ Imaging not usually needed with non-specific neck pain unless warranted for differential diagnosisMRI helps to visualize compressed or inflamed nerve root in diagnosisX-ray/plain-film radiograph helpful if osteophyte located in intervertebral foramenCT to show herniation compressing the spinal canal/nerves6Electrodiagnostic/nerve conduction testing can help to determine specific impaired nerve function ++ Diagnostic Procedures +... GET ACCESS TO THIS RESOURCE Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. Access My Subscription GET ACCESS TO THIS RESOURCE Subscription Options Pay Per View Timed Access to all of AccessPhysiotherapy 24 Hour $34.95 (USD) Buy Now 48 Hour $54.95 (USD) Buy Now Best Value AccessPhysiotherapy Full Site: One-Year Individual Subscription $595 USD Buy Now View All Subscription Options