Remember that even in modern days it is difficult to pinpoint accurately the cause of neck pain. Sitting at the computer for the whole day, watching TV for hours together, holding the mobile cellphone more or less the whole day (including while driving), position of the neck while sleeping in bed, etc. any or all could be the causes. I would like to stress that even if cervical spondylosis is the cause of neck pain with or without some root pain, it is with the passage of time that the pain will disappear.
The root pain could be due to either compression, fibrosis or ischaemia due to osteophytes. In the past, I was very confident of prescribing cervical collar for a long time. Lately, it has been shown that all the cervical collars used for a long time have only a placebo effect. In addition they also reduce the muscle tone and increase stiffness of the neck muscles. Therefore, we should start advising patients to wear a collar only for acute severe exacerbations and thereafter to be used SOS during a particular time of activity involving neck movement.
Depend only on “passage of time” and encourage the patient for the same. Most of them become alright within a few weeks. Do’s and don’ts are more important in recovery.
STATINS FOR SEPSIS
‘Randomised trials of statins for prevention of sepsis are warranted’
Atherosclerosis and sepsis share several pathophysiological similarities, leading to speculation that statins, which are beneficial in atherosclerosis, might also be effective against sepsis. Daniel Hackam and colleagues assessed information from linked databases in Canada to examine the effect of statins on sepsis in a high-risk population with atherosclerosis. They found that incidence of sepsis was lower in patients who received statins than in those who did not. In a Comment Marc Merx and Christian Weber warn that large RCTs are required to build a stronger evidence base for this exciting preventive approach.
Lancet, 2006; 372, 413. |
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