Dangerous Neck Crack
Latrina Mosely
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The U.S. Food and Drug Administration (FDA) is warning parents, caregivers, and health care providers not to use neck floats with babies for water therapy interventions, especially with babies who have developmental delays or special needs, such as spina bifida, spinal muscular atrophy (SMA) type 1, Down syndrome, or cerebral palsy. The use of these products can lead to death or serious injury.
The FDA is aware that some manufacturers are claiming these products support water therapy interventions in babies with developmental delays or special needs and that the benefits of these products include increased muscle tone, greater flexibility and range of motion, increased lung capacity, better sleep quality, and increased brain and nervous system stimulation. The safety and effectiveness of neck floats to build strength, to promote motor development or as a physical therapy tool, have not been established.
The FDA is aware of one baby who died and one baby who was hospitalized related to the use of baby neck floats. In both cases the babies were injured when their caregivers were not directly monitoring them.
While the FDA believes that death or serious injury from neck floats is rare, health care providers, parents, and caregivers should be aware that these events can and do occur. It is also possible that some cases have not been reported to the FDA.
The FDA is informing parents, caregivers, and health care providers of the risk to babies who use neck floats, especially babies with developmental delays or special needs, while we work with external stakeholders to increase awareness of the issue.
Recently, the FDA became aware of companies marketing neck floats for use as a water therapy tool without FDA clearance or approval. The FDA has communicated our concerns about these promotional materials to these companies and will continue to monitor promotional materials and claims for these devices.
If you experience adverse events associated with using neck floats, we encourage you to file a voluntary report through MedWatch, the FDA Safety Information and Adverse Event Reporting program. Health care personnel employed by facilities that are subject to FDA's user facility reporting requirements should follow the reporting procedures established by their facilities.
If you believe a medical device is being marketed outside the scope of its FDA approval or clearance, you can report that allegation through FDA's Allegations of Regulatory Misconduct process. You can also contact your local FDA Consumer Complaint Coordinator for assistance with this process.
Rarely, neck pain can be a symptom of a more serious problem. Seek medical care for neck pain with numbness or loss of strength in the arms or hands or for pain that shoots into a shoulder or down an arm.
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Most neck pain is associated with poor posture combined with age-related wear and tear. To help prevent neck pain, keep your head centered over your spine. Some simple changes in your daily routine may help. Consider trying to:
If a stiff neck is the result of a condition other than a strain or sprain, oftentimes other symptoms will also be present. In such cases, typically at least one other symptom will develop with or before the stiff, painful neck occurs.1Bacterial meningitis. Centers for Disease Control and Prevention Website. . Updated January 25, 2017. Accessed February 13, 2017.
According to the Centers for Disease Control and Prevention (CDC), a fever, headache, and stiff neck (inability to flex the neck forward, also called nuchal rigidity) are typically early symptoms of bacterial meningitis.1Bacterial meningitis. Centers for Disease Control and Prevention Website. . Updated January 25, 2017. Accessed February 13, 2017. When any two of these symptoms are present together, they should be immediately checked out by a doctor.
A neck spasm, also referred to as a cramp, involves the muscle strongly contracting without relaxing again. A neck spasm can also feel like a muscle twitch in which the muscle rapidly contracts and relaxes over and over.
While the exact mechanisms for how neck spasms develop are not well understood, they are commonly thought to be caused by either the muscle trying to protect itself or receiving altered motor signals.
A muscle can also receive altered motor signals because of an abnormality in the nerve pathways or brain. Potential examples include stress, anxiety, peripheral neuropathyPeripheral Neuropathy Fact Sheet. National Institutes of Health, National Institute of Neurological Disorders and Stroke. -Caregiver-Education/Fact-Sheets/Peripheral-Neuropathy-Fact-Sheet. Accessed January 10, 2020., or cervical dystoniaCervical Dystonia. National Organization of Rare Disorders (NORD). -diseases/cervical-dystonia. Accessed January 10, 2020..
This site is for educational purposes only; no information is intended or implied to be a substitute for professional medical advice. The information is produced and reviewed by over 200 medical professionals with the goal of providing trusted, uniquely informative information for people with painful health conditions.
Deep neck infections are a serious but treatable group of infections affecting the deep cervical space and characterized by rapid progression and life-threatening complications. These infections remain an important health problem with significant morbidity and potential mortality. These infections most frequently arise from the local extension of infections from tonsils, parotid glands, cervical lymph nodes, and odontogenic structures. They classically present with symptoms related to local pressure effects on the respiratory, nervous, or gastrointestinal (GI) tract (particularly neck mass/swelling, dysphagia, dysphonia, and trismus). This activity reviews the proper evaluation and management of this condition.
Objectives:
- Summarize the epidemiology of deep neck infections.Describe the typical clinical presentation of deep neck infections.Identify the management options for deep neck infections.Explain the importance of collaboration amongst interprofessional teams to providing optimal management to patients with deep neck infections.
Deep neck infections are a serious but treatable group of infections affecting the deep cervical space and characterized by rapid progression and life-threatening complications. These infections remain an important health problem with significant morbidity and potential mortality. These infections most frequently arise from the local extension of infections from tonsils, parotid glands, cervical lymph nodes, and odontogenic structures. They classically present with symptoms related to local pressure effects on the respiratory, nervous, or gastrointestinal (GI) tract (particularly neck mass/swelling/induration, dysphagia, dysphonia, and trismus). The specific presenting symptoms will depend on the deep neck space involved (parapharyngeal, retropharyngeal, prevertebral, submental, masticator, etc).[1][2][3][4][5]
Deep neck space infections are almost uniformly polymicrobial, representing their origin from the normal flora of the oral cavity and upper respiratory tract. The most common source of deep neck infections among adults are the dental and periodontal structures, with the second most common source being from the tonsils. Tonsil and pharyngeal sources are the most common etiologies in children. Streptococcus viridans,Staphylococcus aureus, Klebsiella, gram-negative rods, anaerobes, Fusobacterium species are all frequently encountered microorganisms, representing pathologic overgrowth of expected oropharyngeal flora. Actinomyces, Mycobacterium, and fungi are also potential causative organisms but are rarer. The presence of risk factors such as immunocompromised state, diabetes mellitus, intravenous (IV) drug use, as well as the site of origin of infection, influences the type of causative organism.[6]
Deep neck infections account for approximately 3,400 hospitalizations annually in the United States. A study using the Kids' Inpatient Database (KID) to determine the incidence of deep neck infections found that the incidence of retropharyngeal abscess increased significantly from 0.1/10,000 in 2000 to 0.22/10,000 in 2009. The incidence of peritonsillar abscess in 2009 was 0.94 cases/10,000, and that of parapharyngeal abscess was 0.14 cases/10,000.
To understand the pathophysiology of deep neck infections it is essential to have a thorough understanding of the cervical compartments and interfascial spaces. The cervical fascia can be divided into superficial and deep fascia. The superficial fascia is the subcutaneous tissue of the neck and contains the platysma. This layer completely envelops the head and neck. The deep fascia of the neck is divided into superficial, middle, and deep layers. The superficial layer of the deep fascia covers the submaxillary and parotid glands, the trapezius, sternocleidomastoid, and strap muscles. It is also termed the investing layer. Infections of odontogenic and submandibular origin affect this space, which includes the submandibular and masticator spaces. The middle layer encloses vital parts of the neck including the pharynx, larynx, trachea, upper esophagus, thyroid, and parathyroid glands. Infections of pharyngeal, tonsillar, and laryngeal origin affect this space, which includes the parapharyngeal and retropharyngeal spaces. This space can also become involved by odontogenic infections of the 2nd and 3rd molars, where infection can spread inferior to the dentate line of the mandible to penetrate the middle layer of deep cervical fascia. The deep layer of the deep cervical fascia, also called prevertebral fascia, covers the vertebral column and muscles of the spine. There is an alar fascia present in this space that forms the terminus of the retropharyngeal space and lies between the middle layer fo deep cervical fascia and the prevertebral fascia proper. The space between this alar layer and the prevertebral fascia is the so-called "danger space," as it is in continuity with the mediastinum and infections of upper aerodigestive origin can spread freely to cause mediastinitis. True retropharyngeal infections can involve the deep layer of deep cervical fascia, but the hematogenous spread of other infections (i.e. in IV drug users) can lead to vertebral and prevertebral abscesses.
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