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The Incidence of Somatic Dysfunction in Patients with Sudden Onset Atraumatic Neck Pain: A Retrospective Case Note Study

Journal: The AAO Journal Date: 2016/09, 26(3):Pages: 9-19, type of study: retrospective study

Full text    (https://www.academyofosteopathy.org)

Keywords:

neck pain [132]
cervical spine [210]
somatic dysfunction [147]
osteopathic manipulative treatment [2973]
OMT [2951]
retrospective study [213]

Abstract:

Abstract: Background: Sudden onset atraumatic neck pain is a common complaint, but few studies have investigated this condition. Objective: To determine the incidence of somatic dysfunction in patients with sudden onset atraumatic neck pain and to assess the immediate responses of the patients to osteopathic manipulative treatment (OMT). Design: Electronic billing records dated between March 2001 and December 2011 from a neuromusculoskeletal medicine and osteopathic manipulative medicine (NMM/OMM) specialty clinic were retrospectively searched for outpatient clinical encounters that were diagnosed with neck pain or neck strain. Methods: More than 1000 medical records of patients who were diagnosed with neck pain or neck strain were reviewed for sudden onset pain without precipitating trauma. From the 50 records meeting these criteria, data were collected for demographic characteristics, medical history, signs and symptoms, somatic dysfunctions, types of OMT techniques used, and immediate response to OMT. Results: Of 1092 neck pain clinical encounters, 50 patients reported sudden onset atraumatic neck pain. Of those 50, patient ages ranged from 10 to 85 years (mean 44 years) and 37 (74%) were female. Twenty-nine patients (58%) had pain onset upon waking. Somatic dysfunctions were documented for 43 patients (86%) in the cervical region, 46 (92%) in the thoracic region, 36 (72%) in the rib region, 13 (26%) in the lumbar region, 8 (16%) in the sacral region, 6 (12%) in the pelvic region, and 5 (10%) in the cranial region. The most commonly documented muscle spasms were the right levator scapulae and left trapezius (9 patients [18%] for both). Of the 50 patients, 47 (94%) received OMT. The most commonly used OMT techniques included myofascial release used on 30 patients (60%); muscle energy on 26 (52%); highvelocity, low-amplitude on 24 (48%); articular technique on 23 (46%); and counterstrain on 14 (28%). Forty-four patients (88%) reported improved symptoms immediately after OMT. Conclusions: The incidence of cervical, thoracic, and rib somatic dysfunction in patients presenting with sudden onset atraumatic neck pain was very high. Females were more likely to present to the clinic with these symptoms, and the onset most commonly occurred on waking. Most patients receiving OMT reported immediate improvement of symptoms.


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