Neck Pain: Initial Evaluation and Management.

Abstract:

:Neck pain is a common presenting symptom in the primary care setting and causes significant disability. The broad differential diagnosis requires an efficient but global assessment; therefore, emphasis is typically placed on red flags that can assist in the early recognition and treatment of more concerning diagnoses, such as traumatic injuries, infection, malignancy, vascular emergencies, and other inflammatory conditions. The critical element in appropriate diagnosis and management of these conditions is an accurate patient history. Physical examination findings complement and refine diagnostic cues from the history but often lack the specificity to be of value independently. Diagnostic tools such as imaging and electrodiagnostic tests have variable utility, especially in chronic or degenerative conditions. Treatment of mechanical or nonneuropathic neck pain includes short-term use of medications and possibly injections. However, long-term data for these interventions are limited. Acupuncture and other complementary and alternative therapies may be helpful in some cases. Advanced imaging and surgical evaluation may be warranted for patients with worsening neurologic function or persistent pain.

journal_name

Am Fam Physician

authors

Childress MA,Stuek SJ

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

150-156

issue

3

eissn

0002-838X

issn

1532-0650

pii

d15039

journal_volume

102

pub_type

杂志文章,评审
  • Prescription to over-the-counter drug reclassification.

    abstract::Self-care is becoming increasingly popular among health care consumers. The availability of over-the-counter medications makes it possible for consumers to treat numerous ailments without the supervision of a health care professional. Many of the medications now available without a prescription were previously classif...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Jacobs LR

    更新日期:1998-05-01 00:00:00

  • Prison medicine.

    abstract::Prisoners in U.S. correctional facilities constitute a unique patient population in need of health services. Physicians who provide medical services to inmates also must interact with prison officials. Drug withdrawal, self-destructive behavior and infectious diseases, including acquired immunodeficiency syndrome, are...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Greenberg MJ

    更新日期:1988-07-01 00:00:00

  • Outpatient anorectal surgery.

    abstract::Fulguration of polyps, rectal biopsy and the Barron method of removing hemorrhoids require no anesthesia. Anal fissures, warts, small fistulas and hemorrhoids can be removed with a minimal amount of anesthesia. Pilonidal cysts or abscesses can also be incised and drained in this manner. Extensive fistulas, unusually l...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Kratzer GL

    更新日期:1975-03-01 00:00:00

  • Synovial cell sarcoma.

    abstract::Synovial cell sarcoma frequently presents as a painful periarticular mass in the lower extremity of a young male patient. The mass may appear encapsulated and is calcified in approximately 50 percent of cases. Surgery is the mainstay of therapy, with radical resection often necessary to prevent local recurrence. The m...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Scialabba FA,DeLuca SA

    更新日期:1990-04-01 00:00:00

  • Esophagogastroduodenoscopy for the family physician.

    abstract::Esophagogastroduodenoscopy is most commonly performed for evaluation of epigastric pain, severe heartburn, chronic nausea and other dyspepsia syndromes that are not relieved by medical therapy. It should not be performed as an in-office procedure in patients with unstable angina, respiratory failure, active upper gast...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Hocutt JE Jr,Rodney WM,Zurad EG,Tucker RS,Norris T

    更新日期:1994-01-01 00:00:00

  • Managing adverse effects of hormonal contraceptives.

    abstract::Adverse effects of hormonal contraceptives usually diminish with continued use of the same method. Often, physi- cians only need to reassure patients that these symptoms will likely resolve within three to five months. Long-acting injectable depot medroxyprogesterone acetate is the only hormonal contraceptive that is ...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Grossman Barr N

    更新日期:2010-12-15 00:00:00

  • Current concepts of digit replantation.

    abstract::Amputated or devascularized digits should be appropriately cooled as quickly as possible. The injured extremity is dressed, splinted and elevated. Careful selection of patients for replantation has yielded satisfying results to both patients and surgeons. Replantation is indicated for a thumb or multiple-digit amputat...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Moore JR,Weiland AJ

    更新日期:1981-07-01 00:00:00

  • Bone scanning.

    abstract::Scanning is based on the uptake of a nuclide by the crystal lattice of bone and is related to bone blood flow. Cancer cells do not take up the tracer. Normally, the scan visualizes the highly vascular bones. Scans are useful and are indicated in metastatic bone disease, primary bone tumors, hematologic malignancies an...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Greenfield LD,Bennett LR

    更新日期:1975-03-01 00:00:00

  • Carpal tunnel syndrome: a practical review.

    abstract::Carpal tunnel syndrome is the most common focal entrapment syndrome. Forceful repetitive activity and vibration may be important workplace risk factors for carpal tunnel syndrome. Although systematic study has suggested that carpal tunnel syndrome is work-related, no clear "dose-response" curve has been found between ...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Katz RT

    更新日期:1994-05-01 00:00:00

  • Palmoplantar hyperhidrosis: a therapeutic challenge.

    abstract::Excessive sweating from the palms and soles, known as palmoplantar hyperhidrosis, affects both children and adults. Diagnosis of this potentially embarrassing and socially disabling condition is based on the patient's history and visible signs of sweating. The condition usually is idiopathic. Treatment remains a chall...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Thomas I,Brown J,Vafaie J,Schwartz RA

    更新日期:2004-03-01 00:00:00

  • Prevention of health care-associated infections.

    abstract::Health care-associated infections cause approximately 75,000 deaths annually, in addition to increasing morbidity and costs. Over the past decade, a downward trend in health care-associated infections has occurred nationwide. Basic prevention measures include administrative support, educating health care personnel, an...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Hsu V

    更新日期:2014-09-15 00:00:00

  • Dorsal penile nerve block for newborn circumcision.

    abstract::Dorsal penile nerve block with lidocaine is safe and effective for reducing the pain associated with newborn circumcision. Administering the anesthesia adds little time or expense to the overall routine. Complications are minor, limited to local bleeding and hematoma formation. Family physicians performing circumcisio...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Fontaine P,Toffler WL

    更新日期:1991-04-01 00:00:00

  • Alopecia in women.

    abstract::Alopecia can be divided into disorders in which the hair follicle is normal but the cycling of hair growth is abnormal and disorders in which the hair follicle is damaged. Androgenetic alopecia is the most common cause of hair loss in women. Other disorders include alopecia areata, telogen effluvium, cicatricial alope...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Thiedke CC

    更新日期:2003-03-01 00:00:00

  • Depression in women: diagnostic and treatment considerations.

    abstract::Women experience depression twice as often as men. The diagnostic criteria for depression are the same for both sexes, but women with depression more frequently experience guilt, anxiety, increased appetite and sleep, weight gain and comorbid eating disorders. Women may achieve higher plasma concentrations of antidepr...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Bhatia SC,Bhatia SK

    更新日期:1999-07-01 00:00:00

  • Radiologic evaluation of chronic neck pain.

    abstract::For many years, there were no guidelines for evaluating patients with chronic neck pain. However, in the past 15 years, considerable research has led to recommendations regarding whiplash-associated disorders. This article summarizes the American College of Radiology Appropriateness Criteria for chronic neck pain. Ima...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Daffner RH

    更新日期:2010-10-15 00:00:00

  • Osteoporosis: effects of calcium.

    abstract::Bone loss coincides with the reduced physical activity of both sexes in later years, vigorously aggravated by age-associated hormonal changes in women and chronic inadequate intake of calcium. In the absence of preventive dietary measures, osteoporosis may become a major health problem for America's fastgrowing senior...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Albanese AA,Lorenze EJ Jr,Wein EH

    更新日期:1978-10-01 00:00:00

  • Slipped capital femoral epiphysis: diagnosis and management.

    abstract::Slipped capital femoral epiphysis is the most common hip disorder in adolescents, and it has a prevalence of 10.8 cases per 100,000 children. It usually occurs in children eight to 15 years of age, and it is one of the most commonly missed diagnoses in children. Slipped capital femoral epiphysis is classified as stabl...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Peck D

    更新日期:2010-08-01 00:00:00

  • Eczematous dermatitis: a practical review.

    abstract::Eczematous dermatitis is a common condition that can interfere with social function, sleep and employment. Its persistence and accompanying pruritus may be stressful and frustrating for patients. The most common and best characterized type of eczema, atopic dermatitis, appears to be increasing in incidence. Other comm...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Zug KA,McKay M

    更新日期:1996-09-15 00:00:00

  • Use of the peak flow meter in office practice.

    abstract::The peak expiratory flow rate (PEFR) may be measured in the office or at home with an inexpensive, hand-held meter. Measurement of the PEFR provides a rapid, objective means of diagnosing and monitoring asthma. Use of the peak flow meter permits early detection of deteriorating function, allowing timely institution of...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Kimmel SR

    更新日期:1986-12-01 00:00:00

  • The mattress sutures: vertical, horizontal, and corner stitch.

    abstract::The interrupted vertical and horizontal mattress suture techniques are two of the most commonly used skin closure methods. These mattress sutures promote wound edge eversion and less prominent scarring. Vertical and horizontal mattress sutures allow for skin edges to be closed under tension when wound edges have to be...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Zuber TJ

    更新日期:2002-12-15 00:00:00

  • Schirmer's test of lacrimation.

    abstract::Schirmer's test is a simple, semiquantitative test of tear production. It is based on the physical tendency of a fluid to travel along a strip of porous material by capillary action due to surface tension. Sterile strips, standardized and prepackaged, are available from local scientific supply houses. The low cost and...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Rodney WM,Louie J,Puffer JC

    更新日期:1981-11-01 00:00:00

  • Evaluating hoarseness: keeping your patient's voice healthy.

    abstract::Hoarseness is the term often used by patients to describe changes in their voice quality. The causes of hoarseness are determined after obtaining a detailed medical history of the circumstances preceding the onset of hoarseness and performing a thorough physical examination. The latter may include visualization of the...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Rosen CA,Anderson D,Murry T

    更新日期:1998-06-01 00:00:00

  • The neuromuscular junction. Part II: myasthenia gravis.

    abstract::Myasthenia gravis is characterized by variable ocular and skeletal muscle weakness. Peak incidence is in young women and older men. Thymomas are present in 30 percent of myasthenic patients over age 40. Binding of acetylcholine receptors by IgG antibodies may be the mechanism of the neuromuscular disorder. Repetitive ...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Brumback RA

    更新日期:1981-02-01 00:00:00

  • Hazards of magnetic resonance imaging.

    abstract::Magnetic resonance imaging uses powerful magnetic fields and a radiofrequency pulse to provide a diagnostic image. Physicians must identify patients with metallic internal implants, pacemakers and cochlear implants before MRI scanning to prevent serious injury. Some patients also experience severe anxiety from the con...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: DeLuca SA,Castronovo FP Jr

    更新日期:1990-01-01 00:00:00

  • Health effects of hawthorn.

    abstract::Hawthorn medicinal extract has long been a favored herbal remedy in Europe. The active components of this slow-acting cardiotonic agent are thought to be flavonoids and oligomeric procyanidins. The most studied hawthorn extracts are WS 1442 and LI 132. Reviews of placebo- controlled trials have reported both subjectiv...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Dahmer S,Scott E

    更新日期:2010-02-15 00:00:00

  • Thyroiditis: a clinical review.

    abstract::Thyroiditis is a spectrum of diseases that includes acute, subacute and chronic thyroiditis, all of which demonstrate the histologic findings of inflammation, fibrosis or lymphocytic infiltration. Acute thyroiditis is an infectious disease characterized by the abrupt onset of anterior neck pain and swelling. Subacute ...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Sakiyama R

    更新日期:1993-09-15 00:00:00

  • Effects of alcohol on bone, muscle and nerve.

    abstract::The acute and chronic effects of alcohol on bone, muscle and peripheral nerves are not well appreciated. Bone complications include traumatic fractures, osteoporosis and osteonecrosis. In muscle, a sustained bout of heavy drinking may cause rhabdomyolysis, while chronic alcohol abuse may produce proximal myopathy. In ...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Hodges DL,Kumar VN,Redford JB

    更新日期:1986-11-01 00:00:00

  • Management of patients after coronary angioplasty.

    abstract::Coronary angioplasty is an accepted method of revascularization in selected patients with coronary artery disease. Immediately after a successful angioplasty, initial management concentrates on the detection and treatment of coronary artery spasm and acute vessel closure, should these complications occur. Once the pat...

    journal_title:American family physician

    pub_type: 杂志文章,评审

    doi:

    authors: Popma JJ,Dehmer GJ

    更新日期:1990-01-01 00:00:00

  • Urinalysis: the physician's responsibility.

    abstract::Careful examination of a fresh, properly collected urine specimen can indicate the presence of urinary tract disease or uncover unsuspected local or systemic pathology. Urinalysis also can lead to a more complete understanding of a systemic disorder or can assure both the patient and the physician that urinary tract d...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: Benejam R,Narayana AS

    更新日期:1985-01-01 00:00:00

  • The acute scrotum.

    abstract::Testicular torsion is characterized by the sudden onset of testicular pain associated with abdominal pain, nausea and vomiting. Fever is unusual and urinalysis is often normal. Fever, pyuria, dysuria and urethral discharge are characteristic of epididymitis. Radionuclide scanning and Doppler ultrasound are helpful in ...

    journal_title:American family physician

    pub_type: 杂志文章

    doi:

    authors: O'Brien WM,Lynch JH

    更新日期:1988-03-01 00:00:00