UNASSIGNED: Cervicogenic headache is characterized by chronic posterior neck pain radiating to one side of the head, resulting from cervical spine bone or soft tissue diseases. Cervical ganglioneuroma (GN), a rare benign neuroblastic tumor, especially in the cervical spine, may cause cervicogenic headache-like symptoms.
UNASSIGNED: We report a case of GN which was surgically removed successfully to relieve the symptom.
UNASSIGNED: A 68-year-old male presented with right posterior neck pain with referred pain to the ipsilateral occipital area in May 2020. Despite administration of medications, physical therapy, and spine interventions, the symptoms intermittently recurred over one year. In July 2021, the patient complained of painful limitation of neck motion, especially on right-sided bending; no motor or sensory deficits, except for subjective numbness of the finger tips, were detected. Plain radiography of the cervical spine showed moderate degenerative changes in the mid-cervical spine. Cervical MRI revealed a cystic mass (1.5 cm × 0.5 cm × 1 cm-in size) around the right C2 dorsal root ganglion adjacent to the C1-C2 facet joint. His symptoms significantly improved after complete tumor excision.
UNASSIGNED: GN of the upper cervical spine should be considered when persistent cervicogenic headache is refractory to conservative management. In such a case, advanced imaging studies such as MRI should be performed for early diagnosis and appropriate treatment.

Alleviation of headaches (HAs), neck pain (NP), and disability is a desirable clinical outcome for the billions globally who suffer from these conditions. Chiropractic BioPhysics® (CBP®) methods may provide an option for head and neck-injured patients. A 62-year-old female historically injured multiple times including two motor vehicle collisions (MVC), and a strike to the face with a hockey puck; all resulting in chronic pain and suffering. The subject sought and received successful treatment in 2016 using this conservative protocol at a facility in the USA. The resolution of symptoms following 36 treatments was previously reported. Following 13 years without treatment beyond home exercises, the subject was re-evaluated and found to be stable in the long term for pain, structural and functional assessment. Thirty-six treatments over 12 weeks in 2016 led to an improvement in numerical pain rating scale (NPRS) for NP (5/10 to 1/10), and HA (9+/10 to 0/10), resolution of NP disability (6/100 to 0/100) as well as normalization of ROM without pain and resumption of all activities of daily living including high-level athletics without pain and disability. A 13-year follow-up found continued stability objectively and subjectively. We provide a case of successful conservative treatment using specific traction, exercises, and spine manipulation procedures. CBP® provides an option to treat pain and this case adds to growing evidence.

Neck pain is a multifactorial condition, and one common cause is cervical spine injury related to motor vehicle collision (MVC). Injuries from MVCs range from whiplash to cervical spine fracture and can manifest in various ways including neck stiffness, decreased range of motion, and neurological deficits. One method of management currently underutilized is osteopathic manipulative treatment (OMT), which can be used to treat pain and range of motion deficits resulting from MVCs. While a few studies in the literature have documented a statistically significant benefit of OMT in chronic pain syndromes, there is little data on its effectiveness in treating patients after MVCs. We present a case of a 25-year-old male who first came to the OMT clinic in January 2021 with complaints of neck pain and stiffness that he attributed to an MVC in February 2020. The collision had led to a loss of consciousness, a concussion, ligamentous injury, and a C5 vertebral fracture. At the OMT clinic, the patient complained of daily headaches associated with \"flashes of numbness\" throughout his whole body and neck stiffness. The patient was treated initially with a full course of physical therapy, but his symptoms plateaued. He has received OMT about once a month for the past two years. He reported an improved range of motion, no further pain, and decreased neurological symptoms at his most recent visit in October 2023. There is scarce high-quality research demonstrating the effectiveness of OMT. To the best of our knowledge, this is the first study in the literature to document the use of OMT to treat a patient with a history of cervical fracture with chronic pain and stiffness after an MVC. The closest correlate found during our review of the literature was a case report outlining the successful treatment of post-concussion syndrome after an MVC. Based on the improvement of refractory neck pain and range of motion our patient gained from OMT, further research involving randomized controlled trials needs to be conducted on this topic.

Recent systematic reviews and meta-analyses show that individuals with chronic neck pain (CNP) have altered respiratory muscle strength and abnormal respiratory mechanics. However, no study has investigated the diaphragmatic function in individuals with CNP compared to asymptomatic peers.
This study aimed to compare the respiratory muscle strength and diaphragmatic function between patients with CNP and asymptomatic controls.
Observational, case-control study.
A total of 25 women with CNP and 23 asymptomatic controls participated in this case-control study. The visual analog scale and neck disability index were used to assess the pain and disability characteristics of the CNP group. Maximum inspiratory and expiratory pressures (MIP and MEP) were measured to determine respiratory muscle strengths. The diaphragmatic function (muscle thickness in deep inspiration, Tins; and at the end of calm expiration, Texp; muscle thickness change, ΔT; contraction ratio, CR) were evaluated by two-dimensional ultrasonography.
The MIP (p = 0.001, d = 1.11), ΔT (p = 0.033, d = 0.63), and CR (p = 0.012, d = 0.75) of the diaphragm were found significantly reduced in the CNP group compared to asymptomatic controls whilst MEP, Tins, and Texp of the diaphragm were similar between study groups (p > 0.05). The intensity of neck pain was moderately correlated with MIP (r = -0.48), Tins (r = -0.46), and ΔT (r = -0.42) while NDI (r = -0.42) had a moderate correlation with Tins (p < 0.05).
The present findings revealed that women with CNP have altered diaphragmatic function. Thus, screening and targeting diaphragm may improve the rehabilitation process in CNP. However, further experimental studies regarding the efficacy of breathing exercise approaches are needed.

(1) Background: Worldwide, asthma, back pain, and migraine are major public health problems due to their high prevalence, effect on the quality of life, and huge economic costs. The association of asthma with an increased risk of these types of pain has been suggested; however, no conclusive results have been obtained to date. The aims of our study were (1) to describe and compare the prevalence of three types of pain localization, namely migraine or frequent headaches (MFH), chronic neck pain (CNP), and chronic low back pain (CLBP), in adults with and without asthma in Spain during the years 2014 and 2020 and (2) to identify which variables were associated with the presence of these types of pain in adults with asthma. (2) Methods: A cross-sectional study and a case-control study were conducted. The 2014 and 2020 European Health Interview Surveys for Spain were used as the data source. (3) Results: A total of 2463 individuals were interviewed and had self-reported asthma. In this group, the prevalence of pain was high, with CLBP (30.9%) being the most common, followed by CNP (26.7%) and MFH (13.3%). All types of pain remained stable from 2014 to 2020. In both surveys, the women with asthma reported a remarkably higher prevalence of all the types of pain analyzed than the men with asthma. After matching by age and sex, the prevalence of all pain types was significantly higher in the patients with asthma than in the matched individuals without asthma. Multivariable adjustment showed that asthma increased the likelihood of CNP by 1.45 times (OR 1.45; 95% CI 1.19-1.76), that of CLBP by 1.37 times (OR 1.37; 95% CI 1.11-1.64), and that of MFH by 1.19 times (OR 1.19; 95% CI 1.02-1.51). The three types of pain analyzed were associated with the female sex and worse self-rated health. (4) Conclusions: Among the men and women with asthma, the prevalence of all the pain types was high and remained stable over time. The prevalence was higher and the severity was greater among the women with asthma than among the men with asthma. The prevalence of any pain was significantly higher in people with asthma than in the sex-age-matched individuals without asthma. Multivariable analysis showed that the variables associated with the reporting of the three types of pain in people with asthma were female sex, worse self-reported health, and self-reported mental illness.

A common cervical spine condition that frequently interferes with a patient\'s daily activities is chronic neck pain. The axioscapular muscle imbalance that results from increased middle trapezius activity in patients with non-specific chronic neck pain affects cervical spine stability and contributes to pain. A 67-year-old male, who was a retired office secretary, experienced neck pain for two years. In the last four months, his discomfort worsened, impairing his ability to function and degrading his quality of life. For the axioscapular muscle imbalance, scapular repositioning with a scapular belt was used to alleviate muscular imbalances and help with posture correction. The results were calculated using the Numerical Pain Rating Scale (NPRS) and the Neck Disability Index (NDI), which revealed significant changes in pain intensity from 9 to 4, and disability scores shifted from 48% to 20% between the pre and post-treatment sessions, respectively. In order to decrease neck pain, this case report investigates the impact of scapular realignment using a scapular belt in the treatment of non-specific chronic neck discomfort.

To evaluate all the cases of chronic neck pain thoroughly to diagnose eagle\'s syndrome. Hospital based prospective study done in the department of otorhinolaryngology at our tertiary care hospital from January 2017 to December 2018. We selected 60 subjects in our study who presented to us with complaints of chronic neck pain associated with referred otalgia, along with aggravation of pain with neck movements, odynophagia, throat pain and foreign body sensation in the throat. After thorough clinical examination an orthopantomogram has been done which revealed elongated styloid process. Conservative management with carbamazepine was tried but only temporary relief was noticed in these patients. Hence intra oral tonsillo-styloidectomy was done and patients were followed up to 3 months. Out of 10 patients, 9 were female and 1 was male. 8 patients had bilateral elongated styloid process and 2 patients had unilateral elongation. Orthopantomogram revealed an average elongation of styloid process of 3.5-5 cm and the average length of the removed styloid process ranged from 0.6-3 cm. All patients showed significant improvement post operatively. Eagle\'s syndrome is not a rarity, but underdiagnosed and missed most of the times. Hence all cases of chronic neck pain should be evaluated thoroughly by taking complete history and proper clinical examination, along with radiological investigations.

Background: Acupuncture and dry needling are increasingly popular treatment modalities used to treat pain around the world. This case report documents the clinical history of a patient who presented to an outpatient physical therapy clinic following surgical removal of two single-use filament needles that fractured in the patient\'s neck during acupuncture treatment. Case Description: The purpose of this case report was to highlight a rare adverse event following acupuncture treatment. The patient received the acupuncture treatment from a practitioner licensed in acupuncture, while on an international business trip. Following the acupuncture treatment, the practitioner realized that a needle had fractured and remained in the patient\'s neck. After failing to retrieve the needle, the patient was sent for imaging. Radiograph revealed that the patient had two needle fragments located in his cervical tissue. After determining that the needles did not pose an immediate threat, the patient boarded a flight home to the United States. Following his flight, the patient presented to an American hospital where it was discovered that the needle fragments had migrated during the flight, with one needle now located 2 mm from the patient\'s vertebral artery. Surgical intervention was required to retrieve the needles, resulting in the patient needing physical therapy to increase cervical range of motion and mediate pain relief. Outcomes: The patient suffered a setback in his treatment of chronic neck pain that resulted in decreased cervical range of motion and increased pain. Discussion: Clinicians utilizing single-use filiform needles in their practice, whether for acupuncture or dry needling, should be aware of the potential for this type of adverse event. Further, to minimize the risk of similar adverse events occurring in the future, clinicians should make sure that they are using high quality needles and make a habit of counting in and counting out the needles that they use to verify that all needles are accounted for.

BACKGROUND: Forward head posture (FHP) and muscular dysfunction are likely contributing factors to chronic neck pain (CNP) but there are inconsistent findings on the relevance of these factors to clinical CNP characteristics.
OBJECTIVE: To compare FHP, cervical muscles size and endurance between CNP and asymptomatic participants and to investigate their association with pain and disability and relative involvement of deep/superficial and flexor/extensor muscles.
METHODS: Thirty-two patients with CNP and 35 asymptomatic participants were included in this case-control study. FHP in standing, extensor and flexor muscles endurance and dimensions were assessed using digital photography, clinical tests and ultrasonographic imaging, respectively. The visual analog scale and neck disability index were also used to evaluate CNP patients\' clinical characteristics.
RESULTS: Deep flexor (mean difference=0.06, 95% CI=0.02-0.11) and extensor muscles size (mean difference=0.07, 95% CI=0.01-0.12) were found to be significantly smaller in CNP patients. CNP patients also demonstrated lower levels of flexor (mean difference=14.68, 95% CI=3.65-25.72) and global extensor endurance capacity. FHP was neither different between the groups nor correlated with any of the dependent variables. Neither FHP nor endurance was correlated with pain/disability. Extensor endurance in both groups and flexor endurance in the asymptomatic group showed significant correlations with muscles size.
CONCLUSIONS: FHP was found neither different between groups nor correlated with muscle performance or CNP clinical characteristics. While cervical endurance was found lower in CNP patients, it did not show any association with pain/disability. The muscular size-endurance relationship seems to become more complex in the presence of NP. While deep muscles seem to be differentially affected in the presence of CNP, the alterations do not seem to be uniform in the flexor and extensor groups.