Misconceived Retropharyngeal Calcific Tendinitis during Management of Myofascial Neck Pain Syndrome

Differential diagnosis of posterior neck pain is very challenging based on symptoms and physical examination only. Retropharyngeal calcific tendinitis is a rare and frequently misdiagnosed entity in various causes of neck pain. It results from calcium hydroxyapatite deposition in the longus colli muscle which is characterized by severe neck pain, painful restriction of neck movement, dysphagia, and odynophagia. We herein report a case of a patient with acute retropharyngeal calcific tendinitis, who complained of posterior neck pain, initially diagnosed and treated as a myofascial neck pain syndrome.

Investigation of the correlation between posterior neck pain and lumbar epidural pressure during percuta-neous endoscopic lumbar discectomy / 临床麻醉学杂志

Objective To investigate the correlation between posterior neck pain and lumbar epidural pressure (LEP)during percutaneous endoscopic lumbar discectomy (PELD).Methods A prospective study was performed on 86 patients undergoing PELD,46 males,40 females,aged 1 9-71 years,with ASA physical status of Ⅰ or Ⅱ.Each patient received lumbar epidural anesthesia.Lum-bar epidural pressure (LEP)was monitored continuously through a lumbar epidural catheter which was connected to a pressure transducer.LEP before the operation (LEPbase ),LEP at the time of pos-terior neck pain (LEPpain )and maximal LEP (LEPmax )were recorded.Results Thirty patients (34.9%)complained of posterior neck pain during the procedure.The lowest LEPmax was 31.0 mm Hg,and the highest LEPmax was 77.0 mm Hg.The LEPmax in patients with neck pain [(60.6± 8.8)mm Hg]was significantly higher than LEPmax in patients without neck pain [(50.7 ± 9.5 ) mm Hg](P <0.01 ).Patients with higher LEPmax had higher probabilities of having posterior neck pain (P <0.01).Conclusion Patients with higher LEPmax had higher probabilities of having posterior neck pain.

Effect of Topical Capsaicin in Chronic Low Back and Posterior Neck Pain

The purpose of this study was to evaluate the effectiveness of topically applied capsaicin cream for the treatment of chronic low back and posterior neck pain. Fourty-one patients with chronic low back or posterior neck pain of more than 6 months despite comprehensive management in our rehabilitation department were selected for this study. Of these subjects, a group of 21 patients used capsaicin cream, and the other 21 patients used NSAID gel as a control group. Pain intensities in both groups were measured with the visual analogue scale(VAS) before the treatment, 2 weeks and 5 weeks after the treatment. McGill Pain Questionnaire(MPQ) was used before and 5 weeks after the treatment. According to followed-up VAS, MPQ-number of words chosen, and MPQ-pain rating index, there was an evidence of effective pain relief by capsaicin cream for the low back and posterior neck pain 5 weeks after the treatment. We conclude that continuous use of capsaicin cream for 5 weeks can be beneficial for the chronic pain patients in relieving pain and subsequently helping their rehabilitation process.