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NGP Neck Pain, Restricted ROM. Pain @ end ROM. No…
NGP Neck Pain
NGP Neck Pain Patient
Screening, History, +- Neuro Exam
Red Flags, Risk Factors, Prognostic Indicators
Category 1
?Fractue
C-Spine Rules
Medical Referral
Category 2
?CAD/Ligamant rupture
Further testing
Definitive diagnosis, Radicular/Radiculopathy,Spinal Stenosis, Fracture
Treat or refer for: medical imaging or medical review
Category 3
Neuro presentation
Futher testing
Neck pain of chemical natue
Pain aggravated by movement, Pain not eased by rest or position, typically constant, pain & stiffness >60 in the am.
Consider med advice and possible medical referral
Mechanical Assessment
Observation
Consider relevance of findings. Forward head posture, head held in asymmetric position
Movement examination
. Physiological and accessory movement tests.
Findings with movement
Important disclaimer: When dissussing posture important to preface with no such thing as "good or bad" rather more or less helpful for a particular patient at a particualr point. Think "mechanical inputs" instead as it relates to load, positon and "tension".
See accompanying G doc for with run sheet of intended videos and videos will aim to flow on from/tie in with Alicias headache vid package
Restricted ROM
. Pain @ end ROM. No significant change in global ROM
Symptomatic stiffness
Restore ROM- mobilise/HVT, Stretch to barrier, sustained EROM load
Forward head posture
Pain from upper Cx segments radiating to head. Increased with movement or posture. Unhelpful motor control
Cerevicogenic headache
(refer and reiterate Alicia's preso and content)
Fear of movement
. Splinting guarding. Sudden onset (e.g Whiplash). Pain early in movement, pain limits movement
Acute pain
e.g Whiplash/raiating arm pain. Reassure, decrease pain, restore movement, educate, protect, graded movement, pain relief (NSAIDS, weak opiods as directed by GP, pharmacist) Cautious application of MT
Full and painless ROM
in all directions, pain with sustained positions
Neck pain with postural pain
Education reduce sustained EROM loading
Diagnostic category