Cervical Spine TBC Flashcards
4 classifications of neck pain per TBC
- neck pain with mobility deficits
- neck pain with radiating pain
- neck pain with movement coordination impairments
- neck pain with headache
TBC algorithm:
If no s/s of nerve root compression, no symptoms distal to elbow, no HA, symptom duration < 30 days, and the pt is > 60 yo, what group do they fall in?
exercise and conditioning
TBC algorithm:
If no s/s of nerve root compression, no symptoms distal to elbow, no HA, symptom duration < 30 days, and the pt is < 60 yo, what group do they fall in?
mobility
TBC algorithm:
If no s/s of nerve root compression, no symptoms distal to elbow, no HA, symptom duration > 30 days, what group do they fall in?
exercise and conditioning
TBC algorithm:
Pt belongs in centralization group if they have these characteristics
- (+) signs of nerve root compression
- (+) symptoms distal to elbow
TBC algorithm:
If no s/s of nerve root compression, no symptoms distal to elbow, (+) HA that is not affected by neck movement and/or pt has a diagnosis or symptoms of migraine, what group do they fall in?
noncervicogenic HA
TBC algorithm:
If no s/s of nerve root compression, no symptoms distal to elbow, (+) HA that is affected by neck movement without a diagnosis or symptoms of migraine, what group do they fall in?
headache
TBC algorithm for patients with neck pain: pain control category
MOI
MVA or other whiplash mechanism
TBC algorithm for patients with neck pain: pain control category
symptom duration
< 30 days
TBC algorithm for patients with neck pain: pain control category
initial pain rating
> 7/10
TBC algorithm for patients with neck pain: pain control category
NDI
score > 52
TBC for neck pain: mobility
These interventions must BOTH be received within the first 3 sessions
- cervical or thoracic mobs/manips
- strengthening exercises for DNF
TBC for neck pain: centralization
Either of these interventions must be received
- mechanical or manual cervical traction (at least 50% of sessions)
- cervical retraction exercises (at least 50% of sessions)
TBC for neck pain: exercise and conditioning
These interventions must both be received in at least 50% of sessions
- strengthening exercises for UQ muscles
- strengthening exercises for neck or DNF muscles
TBC for neck pain: pain control
These interventions must BOTH be received within the first 3 sessions
- cervical spine mobilization
- cervical ROM exercises
TBC for neck pain: pain control
This must not be used
immobilization with cervical collar or similar device
TBC for neck pain: HA
All of these must all be received
- cervical spine mobs/manips
- strengthening for DNF muscles
- UQ strengthening
TBC: centralization
When you suspect a pt belongs in centralization group, what must you r/o first?
UMN pathology
TBC: centralization
radiating pain defined as
narrow band of lancinating pain in the UE
TBC: centralization
What may be present in this group (symptoms)?
- paresthesias
- numbness
- weakness
TBC: centralization
What may be present in this group (imaging)?
- spondylosis (with foraminal narrowing)
- disc herniation
Dermatomes: lateral forearm
C5
Dermatomes: distal thumb
C6
Dermatomes: distal middle finger
C7
Dermatomes: distal 5th finger
C8
Dermatomes: medial forearm
T1
Key muscles for manual testing: deltoid
C5
Key muscles for manual testing: biceps brachii/ECRL/ECRB
C6
Key muscles for manual testing: triceps, FCR
C7
Key muscles for manual testing: abductor pollicis brevis
C8
Key muscles for manual testing: first dorsal interossei (index/middle finger separated)
T1
DTRs: biceps brachii
C5/6
DTRs: brachioradialis
C5/6
DTRs: triceps
C7
