Neck Disability

There are at least two relatively common variants of TD tardive dystonia and tardive akathisia. According to Burke et al. (1982), tardive dystonia involves sustained involuntary twisting movements, generally slow, which may affect the limbs, trunk, neck, or face (p. 1335). The face and neck are by far the most frequently affected areas of the body. Severe deformities of the neck (torticollis) can cause extreme pain and disability. I have seen several cases affecting the orbital muscles of the eyes (blepharospasm) to the degree that the individual s vision was impaired, requiring botulinum (Botox) injections to paralyze the muscles. I have also seen respiratory and abdominal muscles affected in a painful and debilitating manner. 

The risk of causing EPS, another SSRI-induced neurologist disorder, was apparent from early on. The FDA s Kapit (1986) warned, It is possible that a tardive syndrome related to fluoxetine may exist. It will be necessary to be on the lookout for such events (p. 32). By January 1993, more than two dozen reports of Prozac-induced tardive dyskinesia had reached the FDA (1993), but the profession has not taken much notice. Numerous case reports confirm that the SSRIs can produce persistent extrapyramidal reactions, including tardive dystonia with painful and disabling spasms of the neck and shoulder musculature. 

Antecollis is a rare form of tardive dystonia, in which there is forward bending of the neck (331). Patients with this disorder are usually quite disabled and distressed, have severe difficulties with vision, speech, swallowing, and inspiratory obstruction, and are unable to lie supine. In three reported cases (331), the patients developed the symptoms after receiving a number of neuroleptic drugs for 4 months to 14 years. Neither withdrawal of neuroleptic drugs nor the administration of anticholinergic agents affected their symptoms. 

Vestibular disorders are dizziness, unsteadiness, or imbalance when walking. Vertigo, nausea, headache, and muscular aches in the neck and back, motion sickness, and sensitivity to noise and bright lights may be mild (lasting minutes) or severe (resulting in total disability). Meniere s disease, labyrinthitis, and inner ear infections can cause vestibular disorders. Common causes of vestibular disorders follow ... 

Similar stories abound in magazines and newspapers. Larry Feldstein, a former New York City high school teacher, collects 3,300 a month tax-free in a disability pension, yet bills himself as a skilled and graceful ski pro who can execute the perfect turn. On a Mount Snow (Vermont) Web site, Feldstein calls himself a Perfect Turn Ski Pro who is also a certified senior fitness trainer. Feldstein retired in 1994 as a swimming and physical education teacher and was granted a disability pension, ostensibly because he had suffered a neck injury while demonstrating a hockey shot in April 1992. Three doctors on the system s medical board approved the disability. ... 

It may be that these variable responses are directly related to the variability of massage techniques, of which there are over 200. Massage can be given over the whole body or limited to the face, neck, or just hands, feet, legs—depending on the patient and his or her condition or illness, for example, patients with learning disabilities, and many psychiatric patients are often only able to have limited body contact for a short time. 

Recently, one of the two elementary schools suffered the loss of an experienced teacher because of disability from a work-related fall. The teacher was cUmbing on a desk to hang decorations from the ceiling in order to have her classroom presentable for the beginning of the school year. The teacher was wearing dress shoes, and the desk was found overturned. Her back and neck struck another desk on the way to striking the floor. There was not a witness to the incident. A teaching assistant discovered the teacher minutes after the fall. 

A systematic literature search was performed on Pubmed, AMED, CINAHL, PsycINFO, SPORTDiscus and Business Source Premier, from inception to September 2014, using the key words EMG, electromyography, ergonomics, ergonomic, muscle, upper trapezius, shoulder, shoulder pain, shoulder disability, shoulder disorder, musculoskeletal disorders, neck, neck pain, neck disorder, cervical, risk factor, computer, work and labor and boolean operators (AND, OR) were also added to search, with no temporal restriction. Filters for Enghsh language, peer-reviewed studies and human subjects were also applied. 

The levator scapula muscle is frequently involved in neck and posterior shoulder pain. Spasm of this muscle often occurs due to overuse in persons using computers or typewriters. These individuals need to be evaluated for correct posture and ergonomic working conditions. Taking time to stretch and relax the cervical muscles helps prevent this common problem. Untreated, trigger points tend to form in this muscle leading to increased pain and disability. 

The wrist and hand are an important part of a person s ability to function in activities of daily living. Any pain, dysfunction, or disability requires a careful and thorough evaluation of the area. This examination may include the forearm and even other joints of the upper extremity and neck. As with other joints of the upper extremity, a history of the symptom and related information is the first step in the evaluation process. Then the examination may proceed. 

Famque MR, Ikoma K, Mano Y (2004) Surface electromyography of neck, face and head muscles during alternating compression effect in bmshing teeth with Miswak (a tree twig). Saudi J of Disability and rehabilitation 10(3) 214-217... 

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