Neck Pain Tool-kit: Step 3: Difference between revisions
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| width="25%" | [[Image:NeckPainToolkit Step3 Chron ManTher A.jpg|thumb|center|(a) Upper fibres of trapezius stretch]] | | width="25%" | [[Image:NeckPainToolkit Step3 Chron ManTher A.jpg|thumb|center|(a) Upper fibres of trapezius stretch]] | ||
| [[Image:NeckPainToolkit Step3 Chron ManTher B.jpg|thumb|center|(b) Levator scapulae stretch]] | | [[Image:NeckPainToolkit Step3 Chron ManTher B.jpg|thumb|center|(b) Levator scapulae stretch]] | ||
| [[Image: | | [[Image:NeckPainToolkit Step3 Chron ManTher C.jpg|thumb|center|(c) Scalene stretch]] | ||
| [[Image: | | [[Image:NeckPainToolkit Step3 Chron ManTher D.jpg|thumb|center|(d) Push-ups]] | ||
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| | | [[Image:NeckPainToolkit_Step3_Chron_ManTher_E.jpg|thumb|center|(e) Shoulder press]]<br> | ||
| | | [[Image:NeckPainToolkit_Step3_Chron_ManTher_F.jpg|thumb|center| (e) Shoulder press (f) Shrugs]] | ||
| | | [[Image:NeckPainToolkit_Step3_Chron_ManTher_G.jpg|thumb|center|(g) Front raise]] | ||
| | | [[Image:NeckPainToolkit_Step3_Chron_ManTher_H.jpg|thumb|center|(h) Reverse flyes]] | ||
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| | | [[Image:NeckPainToolkit_Step3_Chron_ManTher_I.jpg|thumb|center|(i) Curls]]<br> | ||
| | | [[Image:NeckPainToolkit_Step3_Chron_ManTher_J.jpg|thumb|center|(j) Bent-over rows]] | ||
| | | [[Image:NeckPainToolkit_Step3_Chron_ManTher_K.jpg|thumb|center|(k) Pullovers]] | ||
| | | [[Image:NeckPainToolkit_Step3_Chron_ManTher_L.jpg|thumb|center|(l) Neck extension with pulley]] | ||
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| | | [[Image:NeckPainToolkit_Step3_Chron_ManTher_M.jpg|thumb|center|(m) Flexion with pulley]] | ||
| | | [[Image:NeckPainToolkit_Step3_Chron_ManTher_N.jpg|thumb|center|(n) Rotation with pulley]] | ||
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Revision as of 15:18, 30 March 2012
This page is part of the 'Manual Therapy & Exercise for Neck Pain: Clinical Treatment Tool-kit' resource for clinical decision making, which provides evidence, techniques, and dosages for the use of manual therapy and exercise in the treatment of neck pain. Please see the main project page for further information, or to return to Step 1 to identify your patient. Otherwise, proceed to Step 3 below to inform your technique.
The techniques utilized in the positive trials investigating the use of manual therapy and exercise for the treatment of neck pain are presented below, organized by patient characteristics
- 3.1 Neck pain alone
- 3.2 Neck pain with cervicogenic headache
- 3.3 Whiplash associated disorder
- 3.4 Neck pain with radiculopathy
Once you have found the techniques most applicable to your patient, click on Step 4-inform your technique to see the techniques utilized in the positive studies for that patient population
3.1 Neck pain alone (non-specific)[edit | edit source]
Acute/subacute neck pain[edit | edit source]
- Click to go back to Step 1: Identify your patient
Thoracic manipulation[edit | edit source]
- Click to continue to Step 4: Consider dosage
Cleland 2007[1]
- upper thoracic spine thrust manipulation targeting T1-T4(a)
- patient laces hands behind his/her neck
- therapist uses the patients elbow to flex spine down to the upper thoracic levels
- therapist stabilizes the inferior vertebrae using his/her manipulative hand and uses his/her chest to provide the thrust manipulation. If no pop is heard, a second attempt is made
- middle thoracic spine thrust manipulation targeting T5-T8 (b)
- patient clasps hands on opposite shoulder
- therapist flexes spine down to the target levels using the patients arms
- therapist provides the thrust manipulation through his/her chest. If no pop is heard, a second attempt is made
- Advice to maintain usual activities within the limits of pain
- Advice to maintain current medications
- Adjunct exercise
- place fingers over manubrium and place chin on the fingers
- rotate the head and neck as far as possible to alternating sides
- start using 5 fingers and progress to 4, 3, 2, and 1 finger as mobility improves
- 10 repetitions to each side, 3-4 times/day
Gonzalez-Iglesias 2009[2]
- seated distraction manipulation (c)
- patient seated with arms crossed over the chest and one hand over opposite shoulder and one hand over rib cage
- therapist places his/her upper chest at the level of the patient’s middle thoracic spine
- therapist grasps the patient’s elbows and flexes the thoracic spine until tension is felt
- a distraction manipulation was applied in an upward direction
- if no pop was heard, a second attempt was made
- adjunct electrothermal therapy
Subacute/chronic[edit | edit source]
Manual therapy and exercise[edit | edit source]
Bronfort 2001[3]
- Spinal manipulation to the cervical and thoracic spine (Haldeman and Phillips, 2001) with light soft-tissue massage as indicated to facilitate the spinal manipulative therapy
- Warm-up on a stationary bike with arm levers
- Light stretching as part of warm-up (a-c)
- Upper-body strengthening exercises (Dryssen et al, 1989)
- Push-ups (d)
- Dumbbell shoulder exercises (e-k)
- Dynamic neck exercises lying on table with headgear attached to a simple pulley system
- extension (l)
- flexion (m)
rotation (n)
Unspecified/mixed duration neck pain[edit | edit source]
- Exercise
- Manual therapy
3.2 Neck pain with cervicogenic headache[edit | edit source]
Acute/subacute neck pain with cervicogenic headache[edit | edit source]
Manual therapy and exercise
Exercise
Manual therapy
Chronic neck pain with cervicogenic headache[edit | edit source]
Manual therapy and exercise
Exercise
Manual therapy
3.3 Whiplash associated disorder[edit | edit source]
Acute/subacute whiplash associated disorder[edit | edit source]
Manual therapy and exercise
Exercise
Manual therapy
Chronic whiplash associated disorder[edit | edit source]
Manual therapy and exercise
3.4 Neck pain with radiculopathy[edit | edit source]
Acute neck pain with radiculopathy
[edit | edit source]
Exercise
Manual therapy
References[edit | edit source]
References will automatically be added here, see adding references tutorial.
- ↑ Cite error: Invalid
<ref>tag; no text was provided for refs namedCleland 2007 - ↑ Gonzalez-Iglesias J, Fernandez-De-Las-Penas C, Cleland JA, Del Rosario Gutierrez-Vega M. Thoracic spine manipulation for the management of paitents with neck pain: a randomized clinical trial. J Orthop Sports Phys There 2009;39(1):20–7.
- ↑ Bronfort G, Evan R, Nelson B, Aker PD, Goldsmith CH, Vernon H. A randomized clinical trial of exercise and spinal manipulation for patients with chronic neck pain. Spine 2001;26(7):788-99.
