Neck Pain w/ Mobility Deficits

Question 1

Clinical Presentation

Answer 1

• Central/unilateral neck pain
• limitations in neck motion that reproduces symptoms
• referred pain to the shoulder girdle or UE

Question 2

Tests & Measures

Answer 2

• Cervical ROM including quadrant (can add OP)
• Upper cervical AROM
• Cervical PROM
• Cervical Flexion Rotation Test (CFRT)
• PAIVM (CPA/UPA)
• Palpation

Question 3

Exam Findings

Answer 3

• Limited Cervical ROM
• Neck pain reproduced at end ranges of active or passive motions
• Restriction in cervical and thoracic segmental mobility
• Intersegmental mobility testing reveals characteristics of restriction
• Neck and referred pain reproduced with provocation of the involved cervical or upper thoracic segments or cervical musculature
• Deficits in strength and motor control of the cervicoscapulothoracic area

Question 4

Interventions (manual therapy)

Answer 4

• Up/Down/Side glides
• Supine cervical passive physiological rotation mobilization
• Cervical manipulation and mobilization
• Thoracic manipulation
• PAIVM (CPA/UPA)

Question 5

Exercise

Answer 5

• Cervical ROM, Stretching, and isometric strengthening
• Advice to stay active plus home cervical ROM and isometrics
• supervised exercise, including cervicoscapulothoracic and UE stretching, strengthening, and endurance training
• SNAG
• Augmented Cervical: Flexion, Rotation, Extension
• Self P-A mobilization w/ tennis ball
• Seated cervical extension with excessive thoracic flexion w/ correction
• Quadruped cervical rotation precision training