Classification Approach for Neck Pain Flashcards
What is the difference between a diagnosis and a classification?
Diagnosis- determining the causes of a patient’s illness or discomfort
Classification-process of classifying clinical data into named categories of clinical entities for the purpose of making clinical decisions regarding therapeutic management
What are the 4 subgroups for the classification system?
- Neck pain with mobility deficits
- Neck pain with headache (cervicogenic)
- neck pain with movement coordination impairments
- neck pain with radiating pain
What are the common symptoms and expected exam findings for patients in the neck pain w/ mobility deficits classification?
symptoms
- central or unilateral neck pain
- limits in neck motion that reproduces symptoms
- Referred shoulder girdle or UE pain possible
Findings
- limited cervical ROM
- neck pain reproduced at end range of AROM and PROM
- restricted C and T spine segmental mobility
- neck or referred pain reproduced w/ provocation of involved neck segment
- deficits in strength of involved structures
What are the common symptoms and expected exam findings for patients in the neck pain w/ movement coordination impairments classification?
Symptoms
- mechanism of onset linked to trauma or whiplash
- referred shoulder or UE pain
- associated varied nonspecific concussive SxS
- dizziness/nausea
- concentration or memory problems
Findings
- positive cranial cervical flexion test
- positive neck flexor muscle endurance test
- point tenderness may include myofascial trigger point
- neck pain with mid range motion
- sensorimotor impairments (proprioception, posture, etc.
- neck or referred pain reproduced w/ provocation of involved neck segment
What are the common symptoms and expected exam findings for patients in the neck pain w/ headache (cervicogenic) classification?
Symptoms
- noncontinuous, unilateral neck pain and referred headache
- headache is provoked by head movements or sustained positions
Findings
- positive cervical flexion/rotation test
- headache reproduced with provocation of involved neck segment
- limited Cervical ROM
- strength and endurance deficits
- restricted upper C spine segmental mobility
What are the common symptoms and expected exam findings for patients in the neck pain w/ radiating pain classification?
Symptoms
- neck pain w/ radiating pain to involved UE
- UE dermatomal paresthesia or numbness and myotomal muscle weakness
Findings
- neck and neck related radiating pain reproduced with radiculopathy tests
- may have UE sensory, strength, or reflex deficits associated w/ involved nerve roots
Describe the Acute phase in classifying a patient
- usually highly irritable
- pain experience at rest or w/ initial to mid-range spinal movements: before tissue resistance
Describe the Subacute phase in classifying a patient
- moderate irritability
- pain experienced w/ mid range motions that worsen with end-range spinal movements: with tissue resistance
Describe the Chronic phase in classifying a patient
- Low irritability
- pain that worsens with sustained end-range spinal movements or positions: overpressure into tissue resistance
What intervention strategies are appropriate for the Neck pain w/ mobility deficit classification?
thoracic manipulation
cervical mob/manipulations
ROM/stretching/strengthening
What intervention strategies are appropriate for the Neck pain w/ movement coordination impairment classification?
education/advice -minimize collar use AROM/strengthening proprioceptive exercises cervical manipulations Ice/heat/TENS
What intervention strategies are appropriate for the Neck pain w/ headache classification?
C1-C2 self SNAG
CT mob/manipulations
ROM/stretching/strengthening
What intervention strategies are appropriate for the Neck pain w/ radiating pain classification?
intermittent traction
centralizing exercises
strength exercises
CT mob/manipulations
