Neck

Question 1

What are 4 classifications of neck pain?

Answer 1

-Neck pain with mobility deficits
-Neck pain with movement coordination impairments
-Neck Pain wtih Headache
-Neck Pain with Radiating Pain

Question 2

What are characteristics of neck pain with mobility deficits?

Answer 2

-Central or unilateral neck pain
-Limitation in neck motion that consistently reproduces symptoms
-Associated (referred) shoulder girdle or upper extremity pain may be present

Question 3

What are characteristics of neck pain with movement coordination impairments (WAD)?

Answer 3

-Mechanism of onset linked with trauma or whiplash
-Associated (referred) shoulder girdle or UE pain
-Dizziness/nausea
-Headache, concentration, or memory difficulties, confusion, hypersensitivity to mechanical/thermal/acoustic/odor/light stimuli, heightened affective distress

Question 4

What are characteristics of neck pain with headache (or cervicogenic)?

Answer 4

-Noncontinuous, unilateral nec pain and associated (referred) headache
-Headage is precipitated or aggravated by neck movements or sustained positions/postures

Question 5

What are characteristics of neck pain with radiating pain?

Answer 5

-Pain radiating into the involved extremity
-Upper extremity dermatomal paraesthesia or numbness and myotomal muscle weakness

Question 6

What is treament for neck pain with mobility deficits - if acute?

Answer 6

-Thoracic manipulation
-Cervical mobilization or manipulation
-Cervical ROM, stretching, and isometric strengthening exercise
-Advice to stay active
-Supervised exercise including cervicoscapulothoracic and upper extremity stretching/strengthening/endurance training
-General fitness (staying active)

Question 7

What is treament for neck pain with mobility deficits - if subacute?

Answer 7

-Cervical mobilization or manipulation
-Thoracic manipulation
-Cervicoscapulothoracic exercise

Question 8

What is treament for neck pain with mobility deficits - if chronic?

Answer 8

-Cervical mobilization or manipulation
-Thoracic manipulation
-Cervicoscapulothoracic exercise
-Staying active
-Dry needling, low-level laser, pulsed or high-power ultrasound, intermittent mechanical traction, repetitive brain stimulation, TENS, electrical muscle stimulation

Question 9

What is the clinical prediction rule for cervical thrust techniques?

Answer 9

-Symptoms >38 days
-Positive expectation
-Cervical rotation ROM side to side difference of 10 degrees or greater
-Pain with PA testing of mid-cervical spine

Question 10

What is the rule for cervical thrust on the initial visit?

Answer 10

Start with thoracic manipulation on the first visit, cervical should be used judiciously

Question 11

What is the best test for ruling out cervical radiculopathy?

Answer 11

ULNTT A