Pine mri refer to spine surgery for progressive deficit symptoms fail to improve physical therapy 3-5 times per week for 4-6 weeks starting with gentle range of motion, stretching, massage, tens later employ isometric strengthening and active range of motion see cervical disc herniation rehabilitation provides short term relief does not change the course of the disc disease consider empiric trial of cervical traction if no contraindications and acute muscular pain has resolved consider starting medication to reduce daily pain tricyclic antidepressant (e. viagra without a doctor prescription cheap generic viagra buy viagra online overnight shipping viagra 10 mg reviews G. buy viagra cheap viagra on line overnight generic viagra online Viagra email sent from my yahoo account Amitriptyline) snri (venlafaxine, duloxetine) reevaluate after an additional 4 weeks and obtain cervical spine mri for those failing to improve positive cervical spine mri consider cervical epidural steroid injection or foraminal steroid injection consider spine surgery or neurosurgery consultation negative cervical spine mri consider differential diagnosis (see above) consider rheumatologic cause management: general see cervical disc herniation management conservative management indicated in most cases see cervical disc herniation rehabilitation no danger in observation (except where urgencies exist as describe above) encourage patience do not rush surgical intervention surgery (5% of cases) indications pain and disability intolerable arm pain responds better than neck pain major neurological deficit procedure: affected disc replaced bone graft arthrodesis results arm pain subsides immediately after surgery osteophytes in foramen absorbed in 9-18 months prognosis most patients improve with conservative management recovery may require weeks to months references eubanks (2010) am fam physician 81(1): 33-40 polston (2007) neurol clin 25(2): 373-85 rhee (2007) j am acad orthop surg 15(8): 486-94 cervical disc disorder ( c0477633 ) concepts disease or syndrome ( t047 ) icd10 m50. viagra online buy generic viagra buy viagra women online Viagra cost 5 mg 9, m50 snomedct 425878001, 203832001 english cervical disc disease, cervical disc disord, unsp, cervical disc disorder, unspecified, [x]cervical disc disord, unsp, [x]cervical disc disorder, unspecified, cervical disc disorder (disorder), cervical disc disorder, cervical spine disc disease, [x]cervical disc disorder, unspecified (disorder), cervical disc disorders, cervica. buy viagra online long term side effects of viagra use buy viagra women online buy viagra generic from india Cheap real viagra online viagra triangle chicago bars new viagra commercial drummer buy viagra online
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