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E-Book - Whiplash, Headache and Neck Pain

E-Book - Whiplash, Headache and Neck Pain

Gwendolen Jull | Michele Sterling | Deborah Falla | Julia Treleaven | Shaun O'Leary


Additional Information


A textbook and practical clinical handbook for all students and practitioners concerned with the evaluation, diagnosis, assessment and management of neck pain and cervical headache particularly in relation to whiplash. It is likely to become essential study for final year physiotherapy and chiropractic students, for all manipulative physiotherapy MSc students and a widely used clinical ref text for all involved in the assessment and management of whiplash and related neck and head pain.
 This book presents the applied sciences, clinical assessment methods and rehabilitation protocols for the management of persons with neck pain.
 The material presented in this book represents the translation of research into clinical practice and provides a systematic approach to assessment and an evidence base for conservative clinical management strategies for neck pain.
 Unique topics in this book include:
• Provides an understanding of the pathophysiological processes in the sensory, motor and sensorimotor systems and how they present in patients with neck pain disorders.
• Presents multimodal approaches to management of neck pain guided by the evidence of presenting dysfunctions
• Presents a comprehensive description of a therapeutic exercise approach based on motor control which has proven efficacy.

Table of Contents

Section Title Page Action Price
Front Cover cover
Whiplash, Headache, and Neck Pain iii
Copyright Page iv
Contents v
Preface vii
Foreword ix
Acknowledgments xi
Chapter 1. Introduction 1
Structure of the book 2
References 4
Chapter 2. Sensory Manifestations of Neck Pain 5
Introduction 5
Local cervical spine hyperalgesia – a peripheral nociceptive source of pain? 6
Referred pain 7
Generalized sensory hypersensitivity – evidence of augmented central painprocessing mechanisms 8
The development of sensory disturbances following whiplash injury 10
Neuropathic features of neck pain 12
Influence of sensory changes on patient outcome 13
Implications for the assessment of neck pain patients 13
Implications for the management of neck pain 15
Conclusion 16
References 17
Chapter 3. Structure and Function of the Cervical Region 21
Introduction 21
Structure and function of the cervical spine 21
Muscles of the cervical spine 22
Control of cervical spine posture and motion 24
Motion in the transverse and frontal planes 28
Motion and neck pain 30
Neurovascular structures of the cervical spine 30
Relationship between the cervical spine and thorax 31
Relationship between the cervical spine and shoulder girdle 31
Relationship between the cervical spine and temporomandibular region 34
Conclusion 34
References 35
Chapter 4. Alterations in Cervical Muscle Function in Neck Pain 41
Introduction 41
Changes in muscle strength and endurance 42
Alterations in cervical motor control 42
Peripheral adaptations of the cervical muscles 45
Mechanisms underlying neuromuscular adaptations in neck pain 47
Implications for rehabilitation of people with neck pain 51
Conclusion 54
References 54
Chapter 5. The Cervical Spine and Sensorimotor Control 59
Introduction 59
Morphology of cervical mechanoreceptors 60
Central connections 61
Artificial disturbance of cervical somatosensory input 63
Mechanisms underlying disturbances in sensorimotor control 64
Possible causes of altered cervical somatosensory input 65
Conclusion 68
References 68
Chapter 6. Disturbances in Postural Stability, Head and Eye Movement Control in Cervical Disorders 73
Introduction 73
Dizziness 73
Measures of proprioception, eye movement control, and postural stability 76
Management of disturbances in proprioception, eye movement control, and postural stability 82
Conclusion 83
References 83
Chapter 7. Psychological and Psychosocial factors in neck Pain 87
Introduction 87
Psychological factors and chronic neck pain 88
Psychological factors in transition from acute to chronic neck pain 89
The role of acute posttraumatic stress reaction in the whiplash injury 91
Relationships between physical and psychological factors 92
Psychosocial factors in neck pain 95
Implications for assessment and management of neck pain 96
Conclusion 97
References 97
Chapter 8. Whiplash-associated Disorders 101
Introduction 101
The whiplash condition 102
Classification of whiplash injury 103
Physical and psychological characteristics of whiplashassociated disorders 104
The prediction of outcome following whiplash injury 109
Implications for assessment of whiplash 109
Implications for management 110
Conclusion 112
References 112
Chapter 9. Cervicogenic Headache: Differential Diagnosis 117
Introduction 117
The clinical diagnosis of cervicogenic headache 118
The physical examination in differential diagnosis 122
Conclusion 126
References 127
Chapter 10. Differential Diagnosis of Cervicobrachial Pain 131
Introduction 131
Mechanisms underlying cervicobrachial pain 132
Conservative management of cervicobrachial pain 140
Conclusion 141
References 142
Chapter 11. Clinical Assessment: The Patient Interview and History 145
Introduction 145
“Red flags” 146
Questionnaires: outcomes and diagnostic indicators 146
Communication 148
History of the disorder 148
Presenting symptoms 149
Behavior of symptoms 150
General medical features 152
Clinical reasoning at the conclusion of the patient interview 152
References 152
Chapter 12. Clinical Assessment: Physical Examination of the Cervical Region 155
Introduction 155
The examination in standing 156
The examination in sitting 159
The examination in supine lying 165
The examination in prone lying 169
Continuation of the examination in supine lying 171
The examination in four-point kneeling 175
Assessment of disturbances in sensorimotor control 177
Examination of work tasks 182
Conclusion 183
References 183
Chapter 13. Principles of Management of Cervical Disorders 189
Introduction 189
The patient 190
Management of pain 191
Management of the articular system 193
Management of the neural system 197
Management of the muscle system 198
Management of disturbances in sensorimotor control 199
Work and lifestyle practices 199
Self-management strategies 201
Outcome evaluation 202
References 203
Chapter 14. Therapeutic Exercise for Cervical Disorders: Practice Pointers 207
Introduction 207
Muscle system 208
Phase 1 208
Summary 218
Phase 2 219
Phase 3 222
General remarks 227
References 228
Chapter 15. Future Directions 231
Identification of responders and nonresponders to physical therapies 232
Physiological effects of interventions 233
Intervention techniques 234
Multidisciplinary management 235
Cost-effectiveness 236
Conclusion 236
References 236
Index 239