At Hyatt Regency Pune

10-13 Aug, 2017

Workshop on Neck Pain 

Time 
 Topic 
 Speaker
2:00pm - 
2:15 pm 
Introduction to Neck Pain, Problem Statement, epidemology,  Short Pathophysiology of different types of neck pain 
  Virendra Rastogi 
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Case 1 - Cervical C6 Radiculopathy 
A 36 year old Indian house wife comes to the pain clinic with the complaints of right sided neck pain since 3 and a half months. The pain radiates down the arm till the right hand particularly the thumb and index finger. The patient says that the pain is shooting type and that the thumb and index fingers have become numb for past 1month, though there is no problem with writing. She also feels crawling of ants in the area of pain. She also tells that the limb pain hurts more than the neck pain. She tells that she has not suffered any obvious trauma to the neck. She has no complaints of fever, weight loss, difficulty in walking. Her left arm is absolutely normal. She has tried over the counter analgesics for a month with only slight relief of pain. She has also tried neck massage therapy twice in the last month as advised by her neighbour with only temporary relief. Now her pain is about 7/10 on NRS.
On examination, there is sensory deficit along the radial side of the forearm, thumb and index finger. Motor power of all the fingers is normal and all the deep tendon reflexes are intact. There is mild midline tenderness in the neck. The arm pain aggravates on turning the neck to the right side and with gentle pressure over the head. Plain radiograph of the neck shows straightening of the cervical spine with very few osteophytes.
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 2:15 pm - 2:20 pm
Case 1 presentation and investigation findings 
Rammurthy Kulkarni
 2:20 pm -2:30 pm
Investigation advices, steps to diagnosis for Cervical Radiculopathy 
Pallab Barkakoti
  2:30pm -2:40pm
  Case Discussion with   Treatment Cosideration with evidance for cervical Radiculoathy, 
Rammurthy Kulkarni
2:40pm - 3:05pm
Interventions for Cervical Disc Herniations
Sukdeb Datta
  '
Case 2 cervical facet arthropathy
65 year old senior citizen who was a mathematics professor at a college visits to the outpatient pain services with history of neck pain. The pain started six years back when it was mild but slowly has progressed to become more severe at present. He blames his profession for the neck pain as he had to constantly extend his neck to look up to the black board all these years. Pain is in the mid line and is severe enough to restrict his neck movements. The pain hardly radiates to his arms. Pain is more during neck extension and rotation than forward flexion. There is no history of any neck trauma or neurological deficits. His sleep is not disturbed but his pain is more in the early morning after waking up. He is using cervical collar and analgesics for the past two years after consulting an Orthopaedician.
On examination, the patient has bilateral tenderness  in the paramedian region in the lower part of the neck. Sensory and motor examination is unremarkable. His old x-ray shows extensive degenerative changes in the cervical spine.
 
 3:05pm - 3:10pm
 Case 2 presentation and investigation findings 
 Rammurthy Kulkarni
 3:10pm -
 3:20pm
Investigation advices, steps to diagnosis for Cervical Facet Pain
 Umesh Raval 
  3:20pm -3:30pm
 Case 2 Discussion , Causes of eervical  Facet Arthropathy 
Rammurthy Kulkarni
 3:30pm  -3:45pm
 Treatment Cosideration with evidance for cervical facet arthropathy, Newer Treatment Options  
 Vanmathy V. 
 3:45 pm -4:00pm
 Tea Break 
 
'
  Case 3 - Myofascial pain
A 20 year old college student comes to the pain centre with the history of right sided neck pain since 2 months. He tells that his pain is too severe to attend his classes. The pain comes up to the right shoulder but not beyond. The pain is catching or squeezing type. There is no burning or shooting sensation. He tells that he was involved in extensive badminton training for a month during the summer vacation. He also says that he has no difficulty in writing or riding the bike but cannot bear is laptop bag on his right shoulder. He has no neurological deficits in the right arm. He tells he has not sustained any neck trauma and there is no history of fever.
On examination, neurological examination is absolutely normal. He has severe tenderness in the paramedian region in the right side neck and in the area between the right scapula and the spine. The pain increases on bending the neck laterally towards the left side. There are multiple hard band like structures felt in the tender area on careful palpation.
 
  4:00 pm  - 4:05pm
 Case Presentation and Investigation Findings 
GK Kumar  
  4:05pm  - 4:15pm
 Steps to diagnosis Myofacial Pain 
Samarjit Dey
   4:15 pm  - 4:25pm 
 Case Discussion 
 GK Kumar  
  4:25pm- 
4:35pm
 Treatment Cosideration with evidance  and  Newer Treatment Options  for Myofacial Pain 
Samarjit Dey
'
  Case 4 Cervicogenic headache
A 35 year old lady comes to the pain clinic with the history of left sided neck pain since 6 months. The pain is always on the left side and radiates to the left half of the head. It is present almost throughout the day  with minimal relief in between. She is a software engineer by occupation and her pain is more after working for few hours on her computer. The pain is deep, boring, non-throbbing and at times pain comes down the shoulder till the arm. She tells that she feels nauseating when the pain severity increases. She cannot tolerate loud sound on the television and tries to avoid excess brightness on her computer during pain. She never had trauma to the neck or head and she has no fever, weakness in the left arm.  She has consulted a general physician for the same and was told that she has migraine headache. She takes paracetamol 500 mg along with sumatriptan 100mg a day for the past 3 months and she is not happy with the relief.
On examination, her neck movements are greatly restricted. There is severe tenderness in the paramedian region and in the occipital region on the left side. No neurological deficits noted. X-ray of the cervical spine shows no abnormality.
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4:35 pm - 
4:40 pm
 Case 4 presentation and investigation findings 
  GK Kumar 
 4:40pm- 
4:50pm
 Investigation advices, steps to diagnosis for Cervicogenic headache
Jaya Choudhary
4:50pm - 5 :00 pm
Case Discussion with treatment  for Cervicogenic headache
 GK Kumar