the back pain neck pain and headache relief center santa barbara
Chapter 016. Back and Neck Pain (Part 1) ppsx
Ngày tải lên :
06/07/2014, 08:20
... Chapter 016. Back and Neck Pain
(Part 1)
Harrison's Internal Medicine > Chapter 16. Back and Neck Pain
Back and Neck Pain: Introduction
The importance of back and neck pain in our ... greatest. The disks are elastic in youth and allow the bony
vertebrae to move easily upon each other. Elasticity is lost with age. The function
of the anterior spine is to absorb the shock ... The anterior portion of the spine consists of cylindrical vertebral bodies
separated by intervertebral disks and held together by the anterior and posterior
longitudinal ligaments.
The...
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Chapter 016. Back and Neck Pain (Part 3) ppsx
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06/07/2014, 08:20
... "sclerotomal" pain may explain some cases of back and leg pain without evidence
of nerve root compression.
Radicular back pain is typically sharp and radiates from the lumbar spine to
the leg within the ... elicit the radiating pain. The pain may increase in
postures that stretch the nerves and nerve roots. Sitting stretches the sciatic nerve
(L5 and S1 roots) because the nerve passes posterior to the ... herniation
than the SLR sign. The nerve or nerve root lesion is always on the side of the pain.
The reverse SLR sign is elicited by standing the patient next to the examination
table and passively...
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Chapter 016. Back and Neck Pain (Part 4) docx
Ngày tải lên :
06/07/2014, 08:20
... Chapter 016. Back and Neck Pain
(Part 4)
The neurologic examination includes a search for focal weakness or muscle
atrophy, focal reflex changes, diminished sensation in the legs, and signs ...
The examiner should be alert to the possibility of breakaway weakness,
defined as fluctuating strength during muscle testing. Breakaway weakness may
be due to pain or a combination of pain ... combination of pain and underlying true weakness.
Breakaway weakness without pain is due to lack of effort. In uncertain
cases, electromyography (EMG) can determine whether or not true weakness...
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Chapter 016. Back and Neck Pain (Part 5) pps
Ngày tải lên :
06/07/2014, 08:20
... imaging of the lateral recess of the spinal canal and bony lesions and is tolerated
by claustrophobic patients. While the added diagnostic value of modern
neuroimaging is significant, there is ... by pain or poor
effort. EMG and nerve conduction studies will be normal when only limb pain or
sensory nerve root injury or irritation is present.
Causes of Back Pain
Table 16-3 Causes of Back ... Pain
Table 16-3 Causes of Back and Neck Pain
Congenital/developmental
Spondylolysis and spondylolisthesisa
Kyphoscoliosis
a
Spina bifida occulta
a
Tethered spinal cord
a
Minor...
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Chapter 016. Back and Neck Pain (Part 8) ppsx
Ngày tải lên :
06/07/2014, 08:20
... features include morning back stiffness, nocturnal
pain, pain unrelieved by rest, an elevated ESR, and the histocompatibility antigen
HLA-B27. Onset at a young age and back pain improving with exercise ... Surgical foraminotomy results in long-term
relief of leg and back pain in 80–90% of these patients. The usefulness of
therapeutic facet joint blocks for pain has not been rigorously studied.
Arthritis ... Loss of the normal lumbar lordosis and exaggeration of thoracic
kyphosis develop as the disease progresses. Inflammation and erosion of the outer
fibers of the annulus fibrosus at the point...
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Chapter 016. Back and Neck Pain (Part 9) docx
Ngày tải lên :
06/07/2014, 08:20
... space. The fibrosis results in
nerve root adhesions, and presents as back and leg pain associated with motor,
Chapter 016. Back and Neck Pain
(Part 9)
Neoplasms
(See also Chap. 374) Back pain ... is found, the possibility
of bacterial endocarditis should be considered. Back pain exacerbated by motion
and unrelieved by rest, spine tenderness over the involved spine segment, and an
elevated ... intrathecal hemorrhage,
myelography (rare), intrathecal injection of glucocorticoids or anesthetics, and
foreign bodies. The MRI shows clumped nerve roots located centrally or adherent
to the...
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Chapter 016. Back and Neck Pain (Part 10) pdf
Ngày tải lên :
06/07/2014, 08:20
... lumbar pain
may be a symptom of ureteral obstruction due to nephrolithiasis.
Other Causes of Back Pain
Postural Back Pain
There is a group of patients with nonspecific chronic low back pain ... the body. A lesion in the transverse or proximal
descending colon may refer pain to the mid or left back at the L2-L3 level. Lesions
of the sigmoid colon may refer pain to the upper sacral or ... quadrant of the abdomen.
Sacral Pain with Gynecologic and Urologic Disease
Pelvic organs rarely cause low back pain, except for gynecologic disorders
involving the uterosacral ligaments. The pain...
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Chapter 016. Back and Neck Pain (Part 7) ppsx
Ngày tải lên :
06/07/2014, 12:20
... within the spinal canal. Low back pain, weakness and areflexia in the
legs, saddle anesthesia, and loss of bladder function may occur. The problem must
be distinguished from disorders of the lower ... T2 image
on the right reveals a protruding disk at the L5-S1 level (arrows), which displaces
the central thecal sac.
The mechanism by which intervertebral disk injury causes back pain is
controversial. ... the foot and lateral lower calf may result from
Chapter 016. Back and Neck Pain
(Part 7)
MRI of lumbar herniated disk; left S1 radiculopathy. Sagittal T1-
weighted image on the left with...
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Chapter 016. Back and Neck Pain (Part 11) doc
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06/07/2014, 12:20
...
Unidentified
The cause of low back pain occasionally remains unclear. Some patients
have had multiple operations for disk disease but have persistent pain and
disability. The original indications ... antedates the onset of back pain. Preoperative psychological
assessment has been used to exclude patients with marked psychological
impairments that predict a poor surgical outcome.
Unidentified
The ... Chapter 016. Back and Neck Pain
(Part 11)
Psychiatric Disease
CLBP may be encountered in patients who seek financial...
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Chapter 016. Back and Neck Pain (Part 12) pdf
Ngày tải lên :
06/07/2014, 12:20
... spontaneous and reflex
neck movements that exacerbate pain. Evidence regarding the efficacy of ice is
lacking; heat may provide a short-term reduction in pain and disability.
These interventions ... lacking. Randomized studies of back school for primary
prevention of low back injury and pain have failed to demonstrate any benefit.
NSAIDs and acetaminophen (see Table 12-1) are effective over -the- counter ... located distally along the peripheral nerve, or
from anesthesia of the sinuvertebral nerve.
Therapeutic nerve root blocks with injection of glucocorticoids and a local
anesthetic should be considered...
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Chapter 016. Back and Neck Pain (Part 13) pot
Ngày tải lên :
06/07/2014, 12:20
... Chapter 016. Back and Neck Pain
(Part 13)
Chronic Low Back Pain
CLBP, defined as pain lasting >12 weeks, accounts for 50% of total back
pain costs. Risk factors include ...
arm, axilla
a
These muscles receive the majority of innervation from this root.
Neck pain, which usually arises from diseases of the cervical spine and soft
tissues of the neck, is common ...
disease, but the history and examination usually identify a more distal origin for
the pain. Cervical spine trauma, disk disease, or spondylosis may be asymptomatic
or painful and can produce...
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