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<Provider Id="sundheddkcms"> <Item Id="{3CE2B6DF-ACB8-459C-88C2-E6E093D94C79}" Name="nakkemyalgi" Type="LHContentPage" ParentProviderId="sundheddkcms" ParentItemId="{A39CF5B4-3511-4622-9999-7D7339AC8A2F}" SortOrder="400" PublishDate="2010-04-27T14:49:00" DeleteDate="2999-12-31T00:00:00" PotItemType=""> <Content> <HtmlField Name="PageContent"><![CDATA[<h2>Diagnose</h2> <h3>Diagnostiske kriterier</h3> <ul> <li>Baseres på sygehistorien og kliniske fund</li> </ul> <h3>Sygehistorie</h3> <ul> <li>Diffuse, symmetriske smerter i nakke-skulderbuen</li> <li>Oftest brændende eller sviende smerter, ikke særligt intense og de giver sjældent diffus udstråling til skulderblad eller arm</li> <li>Patienten kan have problemer med at bevæge nakken</li> <li>Ledsagende symptomer som træthed, koncentrationssvigt, svimmelhed, øresusen og kvalme peger i retning af stressbetingede nakkesmerter</li> </ul> <h3>Kliniske fund</h3> <ul> <li>Funktionel undersøgelse er nødvendig for at udelukke mekanisk årsag</li> <li>Ved muskulær nakkelidelse vil der være fri bevægelse i alle plan, evt. med lette symmetriske smerter</li> <li>Ved palpation findes øget konsistens, tonus og ømhed</li> <li>Ved udstråling skal nerverodssmerte og overført smerte fra andre organer udelukkes</li> </ul> <h3>Supplerende undersøgelser i almen praksis</h3> <ul> <li>Ingen</li> </ul> <h3>Andre undersøgelser hos specialist</h3> <h4>Røntgen</h4> <ul> <li>Er ikke indiceret</li> </ul> <h4>MR</h4> <ul> <li>Vurder henvisning til specialist og evt. MR</li> <li>Henvisning til MR scanning bør foretages ud fra en betragtning om, at et positivt fund bør få behandlingsmæssig konsekvens. Dette vil oftest være i forbindelse med stillingtagen til evt. kirurgi ved intense og langvarige smerter af mere end 4-6 ugers varighed og ødelægger livskvaliteten, eller der foreligger neurologiske udfald</li> <li>Degenerative forandringer forekommer relativt ofte hos midaldrende og er som regel ikke relateret til symptomer <ul></ul> </li> </ul> <h3>Differentialdiagnoser</h3> <ul> <li>Mekaniske årsager til nakkesmerter</li> <li><a href="~/link.aspx?_id=BE550619ADA34549ABD6E508B5892265&_z=z">Cervikal radikulopati</a></li> </ul> <h2>Behandling</h2> <h3>Behandlingsmål</h3> <ul> <li>Berolige og give indsigt i årsagssammenhænge</li> <li>Mindske smerter</li> </ul> <h3>Generelt om behandlingen</h3> <ul> <li>Afdække disponerende faktorer og give patienten indsigt og forståelige forklaringer</li> <li>Patienterne bør ikke sygemeldes udover få dage. Alternative løsninger som aktiv sygemelding og omskoling bør vurderes tidligt</li> <li>Fysisk træning og fysioterapi kan være aktuelle tiltag</li> <li>Steroidinjektion har ingen plads i behandlingen</li> </ul> <h3>Håndtering i almen praksis</h3> <ul> <li>Udeluk alvorlig sygdom. Patientuddannelse.</li> </ul> <h3>Råd til patienten</h3> <ul> <li>Øvelser, se link til Gigtforeningen: <a href="https://www.gigtforeningen.dk/et-sundt-liv/bevaegelse-og-traening/oevelser/nakke/">https://www.gigtforeningen.dk/et-sundt-liv/bevaegelse-og-traening/oevelser/nakke/</a></li> <li>Tidlig genoptagelse af arbejdet</li> </ul> <h3>Medicinsk behandling</h3> <ul> <li>Medikamenter bør begrænses og gerne undgås, særligt vanedannende</li> <li>Det er god praksis kun at tilbyde peroral <a href="https://pro.medicin.dk/Laegemiddelgrupper/Grupper/213010">NSAID</a> til patienter med nyopståede nakkesmerter efter nøje overvejelse. Behandlingen bør være kortvarig og under nøje hensyntagen til bivirkninger, kontraindikationer og patientpræferencer<a href="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A" data-type="other-reference" data-value="SST NKR 2016" data-url="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A " title="SST NKR 2016"><sup>1</sup></a> </li> <li>Overvej at tilbyde <a href="https://pro.medicin.dk/Laegemiddelgrupper/Grupper/215000">topikale NSAID</a> behandling til patienter med nyopståede nakkesmerter i tillæg til anden behandling med henblik på umiddelbar smertelindring<a href="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A" data-type="other-reference" data-value="SST NKR 2016" data-url="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A " title="SST NKR 2016"><sup>1</sup></a> </li> <li>Det er god praksis kun at tilbyde [DliActiveSubstance;6187;]opiod eller opiod-lignende præparat til patienter med nyopståede nakkesmerter efter nøje overvejelse. Behandlingen bør være kortvarig og under nøje hensyntagen til bivirkninger, kontraindikationer og patientpræferencer<a href="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A" data-type="other-reference" data-value="SST NKR 2016" data-url="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A " title="SST NKR 2016"><sup>1</sup></a> </li> <li>Overvej øvelsesterapi eller ledmobiliserende teknikker frem for peroral smertestillende medicin, som tilbud til patienter med nyopståede nakkesmerter, ved behov for behandling ud over rådgivning og information<a href="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A" data-type="other-reference" data-value="SST NKR 2016" data-url="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A " title="SST NKR 2016"><sup>1</sup></a> </li> </ul> <h3>Anden behandling</h3> <ul> <li>Overvej at tilbyde superviseret øvelsesterapi til patienter med nyopståede nakkesmerter i tillæg til anden behandling<a href="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A" data-type="other-reference" data-value="SST NKR 2016" data-url="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A " title="SST NKR 2016"><sup>1</sup></a> </li> <li>Fysisk træning<a href="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A" data-type="other-reference" data-value="NKR: Ikke kirurgisk behandling af nyopståede uspecifikke nakkesmerter" data-url="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A " title="NKR: Ikke kirurgisk behandling af nyopståede uspecifikke nakkesmerter"><sup>2</sup></a> <ul> <li>I et dansk studie fandt man, at specifik styrketræning (vægte som kunne løftes 8-12 gange, 20 minutter 3 gange per uge) mindskede smerteintensiteten markant, med en varig effekt 10 uger efter ophør af træningen<a href="EditorPage.aspx?da=core&id=%7B3CE2B6DF-ACB8-459C-88C2-E6E093D94C79%7D&ed=FIELD29873090113&vs&la=da&fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&di=0&hdl=H29873090263&us=sitecore%5Canvi&mo&pe=0&fbd=1" title="Andersen, LL, Kjær M, Søgaard K, Hansen L, Kryger AI, Sjøgaard G, Specifik styrketræning mindsker kroniske nakke/skuldermuskelsmerter - sekundærpublikation. Ugeskr Læger 2008;170: 3036" data-type="journal-reference" data-value="Andersen, LL, Kjær M, Søgaard K, Hansen L, Kryger AI, Sjøgaard G, Specifik styrketræning mindsker kroniske nakke/skuldermuskelsmerter - sekundærpublikation. Ugeskr Læger 2008;170: 3036" data-value-piped="Andersen, LL, Kjær M, Søgaard K, Hansen L, Kryger AI, Sjøgaard G|Specifik styrketræning mindsker kroniske nakke/skuldermuskelsmerter - sekundærpublikation|Ugeskr Læger|2008|170|3036" data-url="reference-link"><sup>3</sup></a></li> <li>Konditionstræning mindskede også smerteintensiteten, men kun kortvarigt og i langt mindre grad end styrketræning</li> </ul> </li> <li>Anvend kun massage som behandling til patienter med nyopståede nakkesmerter efter nøje overvejelse, da der ikke er dokumenteret længerevarende effekt selv ved et meget stort behandlingsomfang<a href="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A" data-type="other-reference" data-value="SST NKR 2016" data-url="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A " title="SST NKR 2016"><sup>1</sup></a> <br> <ul></ul> </li> <li>Overvej at tilbyde ledmobiliserende teknikker til patienter med nyopståede nakkesmerter i tillæg til anden behandling<a href="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A" data-type="other-reference" data-value="SST NKR 2016" data-url="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A " title="SST NKR 2016"><sup>1</sup></a> </li> <li>Overvej at tilbyde akupunktur som behandling til patienter med nyopståede nakkesmerter i tillæg til anden behandling<a href="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A" data-type="other-reference" data-value="SST NKR 2016" data-url="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A " title="SST NKR 2016"><sup>1</sup></a></li> </ul> <h3>Kirurgi</h3> <ul> <li>Er sjældent indiceret og kun ved neurologiske udfald med sikker mekanisk årsag verificeret ved MR scanning</li> </ul> <h3>Forebyggende behandling</h3> <ul> <li>Reducere stress. Træning af nakkemuskulatur.</li> </ul> <h2>Henvisning</h2> <ul> <li>Hvis smerterne er intense/langvarige og ødelægger livskvaliteten, eller hvis der foreligger neurologiske udfald</li> </ul> <h2>Opfølgning</h2> <ul> <li>Hvis der kommer neurologiske udfald.</li> </ul> <h2>Sygdomsforløb, komplikationer og prognose</h2> <h3>Sygdomsforløb</h3> <ul> <li>Nakkesmerter går som regel over af sig selv i løbet af dage eller uger</li> <li>De kan recidivere og blive kroniske</li> <li>Er på mange arbejdspladser den hyppigste årsag til sygefravær</li> </ul> <h3>Komplikationer</h3> <ul> <li>Ingen</li> </ul> <h3>Prognose</h3> <ul> <li>Hvis smerterne skyldes overbelastning, har tilstanden en god prognose</li> <li>Ved psykosociale årsager bliver tilstanden oftere kronisk<a href="EditorPage.aspx?da=core&id=%7B3CE2B6DF-ACB8-459C-88C2-E6E093D94C79%7D&ed=FIELD29873090113&vs&la=da&fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&di=0&hdl=H29873090263&us=sitecore%5Canvi&mo&pe=0&fbd=1" title="Jorgensen CK, Fink P, Olesen F, Psychological distress and somatisation as prognostic factors in patients with musculoskeletal illness in general practice. Br J Gen Pract 2000;50: 537-41" data-type="journal-reference" data-value="Jorgensen CK, Fink P, Olesen F, Psychological distress and somatisation as prognostic factors in patients with musculoskeletal illness in general practice. Br J Gen Pract 2000;50: 537-41" data-value-piped="Jorgensen CK, Fink P, Olesen F|Psychological distress and somatisation as prognostic factors in patients with musculoskeletal illness in general practice|Br J Gen Pract|2000|50|537-41" data-url="reference-link"><sup>4</sup></a></li> <li>Hos én af 10 bliver nakkesmerter kroniske, og hos 5 % forårsager tilstanden betydelig nedsat arbejdsevne</li> <li>Blandt personer, som havde haft smerter i mindst 6 måneder, blev 46 % bedre efter behandling</li> <li>Oplysninger om piskesmældsskade forværrer prognosen <ul> <li>Op til 40 % rapporterede symptomer 15 år efter ulykken</li> </ul> </li> </ul> <h2>Baggrundsoplysninger</h2> <h3>Definition</h3> <ul> <li>Smerter i nakken, hvor man ikke finder andre årsager end spændt og smertefuld muskulatur </li> <li>Tilstanden kan forekomme også med diffus udstråling til overekstremiteten (cervicobrachialgi) </li> <li>Smerten kan være muskulært eller mekanisk betinget </li> </ul> <h3>Forekomst</h3> <ul> <li>Incidens <ul> <li>Nakkesmerter forekommer hos 30-50 % af den voksne befolkning i løbet af et år </li> <li>Det er anslået, at 3 % af befolkningen i løbet af et år opsøger læge med nakkelidelse som hovedproblem</li> </ul> </li> <li>Prævalens <ul> <li>Recidiverende smerteperioder er almindeligt helt fra 20-årsalderen </li> <li>I England fandt man blandt kvindelige sygeplejersker, at 34 % havde haft mindst én episode med nakke- eller skuldersmerter over en periode på 13 måneder. Den stærkeste prædiktor for smerte var tidligere gener</li> <li>Blandt danske kvindelige computerbrugere var den årlige prævalens 53 % med mere end 7 dage med nakkesmerter<a href=" " title="Jensen C, Development of neck and hand-wrist symptoms in relation to dur-ation of computer use at work. Scand J Work Environ Health 2003;29: 197-205" data-type="journal-reference" data-value="Jensen C, Development of neck and hand-wrist symptoms in relation to dur-ation of computer use at work. Scand J Work Environ Health 2003;29: 197-205" data-value-piped="Jensen C|Development of neck and hand-wrist symptoms in relation to dur-ation of computer use at work|Scand J Work Environ Health|2003|29|197-205" data-url="reference-link"><sup>5</sup></a></li> </ul> </li> <li>Køn og alder <ul> <li>Hyppigst hos kvinder </li> <li>Øges med alderen, specielt gælder det kroniske gener </li> <li>Akutte anfald er hyppigst hos unge voksne</li> </ul> </li> <li>Konsekvenser <ul> <li>Meget hyppig konsultationsårsag i almen praksis </li> <li>En af de hyppigste årsager til sygefravær</li> </ul> </li> </ul> <h3>Ætiologi og patogenese</h3> <ul> <li>Sandsynligvis multifaktoriel <ul> <li>Dårlig holdning, angst, depression, arbejdsskade, idrætsskade </li> <li>Evt. ensidig monoton belastning</li> </ul> </li> <li>Ved kroniske gener spiller mekaniske og degenerative forandringer en stigende rolle, men grænsen mellem normal aldring og cervical spondylose er vanskeligt at definere </li> <li>Smerten kan være vertebrogen, diskogen eller muskulær </li> <li>I et studie fandt man, at trapezius myalgi var den hyppigste form for gener i nakke- og skulderregionen<a href=" " title="Juul-Kristensen B, Kadefors R, Hansen K et al, Clinical signs and physical function in neck and upper extremities among elderly female computer users: the NEW study. Eur J Appl Physiol 2006;96: 136-45" data-type="journal-reference" data-value="Juul-Kristensen B, Kadefors R, Hansen K et al, Clinical signs and physical function in neck and upper extremities among elderly female computer users: the NEW study. Eur J Appl Physiol 2006;96: 136-45" data-value-piped="Juul-Kristensen B, Kadefors R, Hansen K et al|Clinical signs and physical function in neck and upper extremities among elderly female computer users: the NEW study|Eur J Appl Physiol|2006|96|136-45" data-url="reference-link"><sup>6</sup></a></li> </ul> <h3>Disponerende faktorer</h3> <ul> <li>Den vigtigste disponerende faktor er psykiske forhold<a href=" " title="Jorgensen CK, Fink P, Olesen F, Psychological distress and somatisation as prognostic factors in patients with musculoskeletal illness in general practice. Br J Gen Pract 2000;50: 537-41" data-type="journal-reference" data-value="Jorgensen CK, Fink P, Olesen F, Psychological distress and somatisation as prognostic factors in patients with musculoskeletal illness in general practice. Br J Gen Pract 2000;50: 537-41" data-value-piped="Jorgensen CK, Fink P, Olesen F|Psychological distress and somatisation as prognostic factors in patients with musculoskeletal illness in general practice|Br J Gen Pract|2000|50|537-41" data-url="reference-link"><sup>4</sup></a></li> <li>Stress <ul> <li>Psykisk stress og somatisering er vigtige prædiktorer for varighed af generne</li> </ul> </li> </ul> <h3>ICPC-2</h3> <p>[ICPC]</p> <h3>ICD-10/SKS-koder</h3> <p>[ICD10]</p> <h2>Patientinformation</h2> <h3>Hvad man bør informere patienten om</h3> <ul> <li>Det er god praksis at fokusere på tryghedsskabende information i rådgivning af patienter med nyopståede nakkesmerter<a href="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A" data-type="other-reference" data-value="SST NKR 2016" data-url="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A " title="SST NKR 2016"><sup>1</sup></a></li> <li>Muskulære nakkesmerter er meget almindelige. De kan skyldes akut overanstrengelse eller oftere stress eller psykiske forhold</li> <li>Om behandlingsmuligheder</li> <li>Tilrettelagt arbejde og aktiv sygemelding kan ofte være bedre end langtidssygemelding</li> </ul> <h3>Hvad findes der af skriftlig patientinformation</h3> <ul> <li>Anvend kun skriftlig rådgivning med fokus på tryghedsskabende information efter nøje overvejelse, hvis skriftlig information står alene<a href="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A" data-type="other-reference" data-value="SST NKR 2016" data-url="https://www.sst.dk/-/media/Udgivelser/2016/NKR-nakkesmerter/Rapport_NKR45.ashx?la=da&hash=D627CD8CFCE467B4727A7ED3A29C9C9F9F523E1A " title="SST NKR 2016"><sup>1</sup></a></li> <li><a href="~/link.aspx?_id=6B51090F438044D68859006FD2C1954B&_z=z">Information om nakkemyalgi</a></li> </ul> <h3>Træningsfilm for nakken</h3> <ul> <li><a href="~/link.aspx?_id=5150763DC2E44A27A8A3013FCBABCDB8&_z=z">Øvelsesprogram, 3 øvelser</a><br> <br> <a href="~/link.aspx?_id=97B9C52258F24150B283C20340D5C89D&_z=z"><img alt="" height="84" width="135" src="3BED8D6685EA4EA3AF31CE0A820DC7E4-135-84" style="height: 84px; width: 135px;"></a></li> <li><a href="~/link.aspx?_id=496556C3FAD541E5845A6E7D2838520A&_z=z">Øvelsesprogram, 3 øvelser med arabisk tale - فيديوهات تمارين رياضية باللغة العربية</a><br> <br> <a href="~/link.aspx?_id=BFE9BA69E2F447E1928C10AFC275AC36&_z=z"><img alt="" height="84" width="135" src="69880CC346CC4E1D961DB822FB174DB3-0-0"></a></li> </ul> <h3>Animationer</h3> <ul> <li><a href="~/link.aspx?_id=B21D3FD046CB41B1987298229FF82639&_z=z">Nakkesmerter</a></li> <li><a href="~/link.aspx?_id=ADF5E38160B449EAB983061E42E8E83D&_z=z">Nakkeryggens anatomi</a></li> <li><a href="~/link.aspx?_id=4FF6561CEBD8415DB5D822C74F229FB3&_z=z">Skulderens anatomi</a></li> </ul> <h2>Link til vejledninger</h2> <ul> <li><a href="https://www.sst.dk/da/udgivelser/2016/~/media/F34D82CE7A65475BAB4F31C6BB16567D.ashx">National Klinisk Retningslinje for ikke-kirurgisk behandling af nyopståede uspecifikke nakkesmerter, Sundhedsstyrelsen, 2016</a></li> <li>Forløbsbeskrivelser og regionale pakkeforløb [ICPC]</li> <li><a href="https://vaelgklogt.dk/anbefalinger/opioider">Opioider | Vælg Klogt (vaelgklogt.dk)</a></li> </ul> <h2>Illustrationer</h2> <h3>Billeder</h3> <ul> <li> <a href="~/link.aspx?_id=DB3EA36C44614B1E805FEB8B052CA73F&_z=z">Cervicalcolumna, sidebillede</a> </li> </ul> <h3>Plancher eller tegninger</h3> <ul> <li> <a href="~/link.aspx?_id=925DEA3815A64E3F8E8CC2A98F714DF1&_z=z">Muskulatur i nakke og ryg, tegning</a> </li> <li> <a href="~/link.aspx?_id=20A2AECCC92A47A5911B37DFCFFF4CCE&_z=z">Tensionshovedpine, illustration</a></li> </ul>]]></HtmlField> <HtmlField Name="Resume"><![CDATA[<h2>Resumé</h2> <h4>Diagnose</h4> <ul> <li>Sygehistorie og kliniske fund, hvor der ikke er neurologiske udfald</li> </ul> <h4>Behandling</h4> <ul> <li>Reduktion af stress niveau</li> <li>Træning og udspænding af nakkemuskulatur</li> <li>Evt. kortvarig NSAID</li> </ul> <h4>Henvisning</h4> <ul> <li>Ved neurologiske deficit eller tegn på alvorlig underliggende sygdom</li> </ul>]]></HtmlField> <LinkListField Name="Spot2"> <LinkField linktype="internal">{99A85AFD-2F7A-4B5D-A1C9-C2701D5E7D30}</LinkField> </LinkListField> <TextField Name="DoctorsHandbookID">2785</TextField> <TextField Name="PageTitle">Nakkemyalgi</TextField> <TextField Name="NavigationTitle">Nakkemyalgi</TextField> <CheckBoxField Name="ShowInMenu">true</CheckBoxField> <CheckBoxField Name="ShowInContentField">true</CheckBoxField> <DateTimeField Name="RevisedDate">2024-11-28T09:48:00</DateTimeField> <LinkListField Name="Authors"> <LinkField linktype="internal">{CE2BA99D-50C9-4893-9B3A-504CFF36BD80}</LinkField> <LinkField linktype="internal">{ED7CEC94-3F7A-4FB5-BBB0-A3681BCFC481}</LinkField> </LinkListField> <LinkListField Name="Organization"> 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]]></Media> 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