Cervical dysfunction

• What is cervical dysfunction?
• Statistics on cervical dysfunction
• Risk factors for cervical dysfunction
• Progression of cervical dysfunction
• Symptoms of cervical dysfunction
• Clinical examination of cervical dysfunction
• How is cervical dysfunction diagnosed?
• Prognosis of cervical dysfunction
• How is cervical dysfunction treated?
• References

What is dervical dysfunction?

Cervical spine dysfunction is a cause of neck pain. The cause for it is believed to be a disorder (most likely malalignment) of the pain-sensitive facet joints (which may also be due to disc disruption). Dysfunction can also cause secondary muscle spasm, which can may lead to more pain and stiffness.
The cervical spine consists of 7 cervical vertebrae (back bones) which connect the base of the skull to the thoracic (rib) cage. These vertebrae articulate with one another via intervertebral joints – these include the discs and the facet joints.

Statistics on cervical dysfunction

Cervical dysfunction is the most common cause of neck pain. It affects both males and females and is common in all age groups – but most common in those 12 to 50 years of age.

Risk factors for cervical dysfunction

The disorder is believed to be due to either:

• Every day wear and tear, in particular activities requiring neck movements or bending or twisting the neck for a prolonged period of time (e.g. painting a ceiling) sleeping in a twisted position.
• A single injury may also be a cause – e.g. blow to the head or anything that suddenly jerks the neck.

Progression of cervical dysfunction

• The condition is usually self-limiting, though it may recur again after another straining activity or injury.
• Chronic pain may follow some cases, and this may be accompanied by depression.

How is cervical dysfunction diagnosed?

X-rays are usually normal, but may be indicated if there is persistent pain and another cause is suspected, or after an injury.

Prognosis of cervical dysfunction

• This is usually a self-limitng condition. As many as 70% of patients are pain-free after 1 month.
• Chronic neck pain can sometimes follow.

How is cervical dysfunction treated?

• Advice: good upright neck posture, and avoiding straining neck for prolonged periods of time in future or use of excessive number of pillows is important for prevention.
• Heat and massage help with muscle strain.
• Physiotherapy for cervical mobilisation.
• Chronic pain may follow sometimes – this can be treated with facet joint injections of corticosteroid, transcutaneous electrical nerve stimulation (TENS), hydrotherapy, and sometimes antidepressants are indicated if there is secondary depression.

References

• Kumar P, Clark M. CLINICAL MEDICINE. WB Saunders 2002;
• Murtagh, J. General Practice. Second Ed. McGraw-Hill, 1998.