EDS consult
Pantages, Jason
Description
Collection
Title:
EDS consult
Creator:
Pantages, Jason
Date:
1/31/2017
Text:
Hello,
I recently received a call from a physician who specializes in Ehlers Danlos Syndrome (EDS), any help will be greatly appreciated, please see below:
I'm a physician in North Carolina with a special interest in Ehlers Danlos Syndrome (EDS) - the inherited condition in which collagen is defective so joints are hypermobile, i.e. loose. These patients often need long term bracing for, especially, knees, ankles or fingers, to be used in activities that would otherwise cause dislocations.
The neck is a special problem. Often the patient has high, posterior neck pain, that may be relieved by siting with their hands cupped under their jaw, and is relieved by lying down. It may be much better if the patient is supine, and you gently distract the cervical joints by pulling on the occiput. If so, the patient is sometimes helped by a Vista adjustable neck brace. My question is, is there any chance of helping a patient with a customized brace if the Vista doesn't help.
The challenge is, to somehow unload some of the weight of the head off the cervical spine, without putting painful pressure on the TMJs (since these will dislocate easily in these patients and they often have chronic TMJ pain anyway), or on the shoulder ridge - since downward pressure on the shoulders will sublux the upper ribs. And of course, it may be hard to engage the occipital ridge to get the upward pressure in the first place.
The current patient about whom I'm asking this, has had two midcervical fusions, but her neck pain comes back, with some early features of brachial radiculopathy. The exact mechanics we have to improve are impossible to ascertain: the best guide is surely to ease the pain manually with the patient supine, and then see if that position can be reproduced with them upright, by a brace.
Thank you
Jason Pantages M.S., RO
----- Confidentiality Notice -----
The information contained in (or attached to) this electronic message may be legally privileged and/or confidential information. If you have received this communication in error, please notify the sender immediately and delete the message.
I recently received a call from a physician who specializes in Ehlers Danlos Syndrome (EDS), any help will be greatly appreciated, please see below:
I'm a physician in North Carolina with a special interest in Ehlers Danlos Syndrome (EDS) - the inherited condition in which collagen is defective so joints are hypermobile, i.e. loose. These patients often need long term bracing for, especially, knees, ankles or fingers, to be used in activities that would otherwise cause dislocations.
The neck is a special problem. Often the patient has high, posterior neck pain, that may be relieved by siting with their hands cupped under their jaw, and is relieved by lying down. It may be much better if the patient is supine, and you gently distract the cervical joints by pulling on the occiput. If so, the patient is sometimes helped by a Vista adjustable neck brace. My question is, is there any chance of helping a patient with a customized brace if the Vista doesn't help.
The challenge is, to somehow unload some of the weight of the head off the cervical spine, without putting painful pressure on the TMJs (since these will dislocate easily in these patients and they often have chronic TMJ pain anyway), or on the shoulder ridge - since downward pressure on the shoulders will sublux the upper ribs. And of course, it may be hard to engage the occipital ridge to get the upward pressure in the first place.
The current patient about whom I'm asking this, has had two midcervical fusions, but her neck pain comes back, with some early features of brachial radiculopathy. The exact mechanics we have to improve are impossible to ascertain: the best guide is surely to ease the pain manually with the patient supine, and then see if that position can be reproduced with them upright, by a brace.
Thank you
Jason Pantages M.S., RO
----- Confidentiality Notice -----
The information contained in (or attached to) this electronic message may be legally privileged and/or confidential information. If you have received this communication in error, please notify the sender immediately and delete the message.
Citation
Pantages, Jason, “EDS consult,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/242754.
