Neck pain - CPG Flashcards
acute neck pain with radiating pain
utilize mobilization and stabilization exercise
laser
short term use of cervical collar
chronic neck pain with radiating pain
mechanical intermittent cervical traction + stretching and strengthening exercises + c-spine and t-spine manip
encourage participation in occupational and exercise activities
traction contraindications
vertebral fx and dislocation
hypermobility
disease/infection
vertebral artery dysfunction
manual cervical traction benefits
- muscle and joint stretch
- bigger IVD spaces and foramen
- makes centropetally directed forces on disc and soft tissue
- joint mobilization
- increases joint proprioception
- ease compression forces
- improve arterial, venous and lymphatic flow
manual cervical traction
Variety of head and neck positions
Hand should cradle neck contacting one mastoid process
Other hand on chin
Gentle pull
- < 20 pounds
Intermittent pull
- 3 - 10 sec
Treatment time
- 3 - 10 min
cervical traction for cervical radiculopathy
towel traction:
- light pull
- begin with 5-10 min –> 20 mins
manual traction
- flex neck
mechanical traction
20-30 PSI x 5-10 mins
KNOW THE AMOUNT OF PRESSURE PULL
Mechanical cervical traction guideline
Supine
Neck flexed 20 - 30deg
Traction harness pulls on occiput
Intermittent pull
* > 20 pounds
* Minimum of 7 seconds
* Adequate rest time for recovery
Treatment time, 20 - 25 min
force of increased IV separation
forces up to 50 pounds
Cervical Traction Clinical Prediction Rule
- Peripheralization with mobility testing - C4-7
- (+) Shoulder Abduction Test
- Age greater than or equal to 55
- (+) Upper limb tension test
- (+) Cervical Distraction test
Combination of Predictor Variables and Associated Accuracy Statistics
Having at least 3 out of 5 predictors appears to be the optimal threshold for choosing the cervical traction as an intervention
mechanical txn + exercise
or
over door txn + exercise
Mechanical traction + exercise found to decrease disability score and pain intensity compared to only exercise in a subgroup of patients
addition of traction to physical therapy
Mectxn=>decr short & intermed pain; improved disability at intermediate term
Mantxn=>decr pain in short term
