EpistemisVertebral rectification
Specialty: Musculoskeletal.
Why it occurs
- Defensive muscle spasm secondary to acute cervical or lumbar pain
- Whiplash (severe post-collision cervical sprain)
- Disk herniation with acute root compression
- Ankylosing spondylitis (early phase with loss of mobility of the lumbar spine)
- Spondylolisthesis with compensatory readjustment of the pelvis
- Poor long-standing ergonomic postural habits (e.g., standing or rigid sitting)
Initial workup
Lateral x-ray of the cervical or lumbar spine (reveals loss of normal lordotic curvature and vertebral alignment) | MRI of the cervical/lumbar spine (assesses for herniated discs, foraminal stenosis or spinal cord compression) | Electromyography if there are peripheral neurological symptoms.
red flags
Recent-onset cervical or lumbar vertebral rectification associated with progressive muscle weakness in the extremities, alteration in gait coordination (sensory ataxia), tingling in the hands/feet or sphincter incontinence of acute onset (cervical or compressive thoracic myelopathy).
Standard management
- Diazepam — 5 mg orally at night to relieve deep muscle spasm responsible for rectification
- Dexketoprofen — 25 mg every 8 hours orally for 5-7 days
- Paracetamol — 1 g every 8 hours orally
- Pregabalin (75 mg orally every 12 hours in case of associated cervical or lumbar radiculopathy).
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Musculoskeletal
- Listed causes
- 6
- Treatment options
- 4