BOOK
Management of Neck Pain Disorders E-Book
Gwendolen Jull | Deborah Falla | Julia Treleaven | Shaun O'Leary | Jeremy S Lewis
(2018)
Additional Information
Book Details
Abstract
Written by world renowned researchers and clinicians in the field, Management of Neck Pain Disorders provides a comprehensive insight into the nature of neck pain disorders within a biopsychosocial context to inform clinical reasoning in the management of persons with neck pain. Emphasising a patient centred approach, this book practically applies knowledge from research to inform patient assessment and management. It also provides practical information and illustrations to assist clinicians to develop treatment programs with and for their patients with neck pain.
Current issues and debates in the field of neck pain disorders
Research informing best practice assessment and management
Biological, psychological and social features which need to be considered when assessing and developing a management program with the patient
A multimodal conservative management approach, which addresses the presenting episode of pain as well as rehabilitation strategies towards prevention of recurrent episodes
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Management of Neck Pain Disorders | i | ||
| Copyright Page | iv | ||
| Table Of Contents | v | ||
| Foreword | vii | ||
| References | viii | ||
| Preface | ix | ||
| 1 Introduction | 1 | ||
| 1 Neck Pain Disorders | 3 | ||
| Basic tenets of neck pain | 3 | ||
| The biopsychosocial model | 4 | ||
| Contemporary issues | 5 | ||
| Classification of neck pain | 5 | ||
| Defining the neck pain disorder by mechanism of onset | 6 | ||
| Defining the neck pain disorder by pathoanatomy | 6 | ||
| Defining the neck pain disorder by time | 7 | ||
| Defining the neck pain disorder by mechanisms | 7 | ||
| Defining the neck pain disorder by predictors | 8 | ||
| Defining the neck pain disorder by clinical prediction rules | 8 | ||
| Defining the neck pain disorder by subgrouping | 8 | ||
| Management of neck pain disorders | 9 | ||
| Effectiveness and ineffectiveness; responders and non-responders | 9 | ||
| Single or multimodal interventions | 9 | ||
| Neck pain—an episodic or a recurrent disorder | 10 | ||
| Conclusion | 10 | ||
| References | 10 | ||
| 2 Clinical Sciences | 15 | ||
| 2 Nociception and Pain Perception | 17 | ||
| Introduction | 17 | ||
| The nociceptive pathway: from noxious stimuli to pain perception | 17 | ||
| Nociceptive pain | 19 | ||
| Neuropathic pain | 20 | ||
| Inflammatory pain | 21 | ||
| Peripheral and central sensitization | 21 | ||
| The influence of psychological factors | 22 | ||
| Psychosocial influences on pain perception | 24 | ||
| Conclusion | 25 | ||
| References | 25 | ||
| 3 Movement and Posture in Neck Pain Disorders | 29 | ||
| Cervical posture | 29 | ||
| Movement of the cervical spine | 29 | ||
| Movements of the craniocervical region | 30 | ||
| Movements of the cervical region (C2–7) | 31 | ||
| Movements of the cervicothoracic region (C7-T4) | 31 | ||
| Integrated segmental motion | 31 | ||
| Relationships to adjacent regions | 32 | ||
| The cervical spine and upper limb | 32 | ||
| The cervical spine and the craniomandibular region | 33 | ||
| Cervical posture and neck pain disorders | 34 | ||
| Cervical movement disturbances in neck pain disorders | 35 | ||
| Range of motion | 35 | ||
| Movement performance | 35 | ||
| Psychological considerations | 36 | ||
| Conclusion | 36 | ||
| References | 36 | ||
| 4 Neural Tissue in Neck Pain Disorders | 41 | ||
| Nerve injury and neck pain disorders | 41 | ||
| Pathophysiological mechanisms of nerve injury—the basis for clinical presentation and examination procedures | 41 | ||
| Pathophysiological mechanisms of neuropathy in neck pain disorders | 41 | ||
| Musculoskeletal injury and perineural inflammation | 42 | ||
| Nerve entrapment and compression | 42 | ||
| Traumatic nerve injury | 42 | ||
| Clinical manifestations of neuropathy and relationship to examination findings | 43 | ||
| Patient reported symptoms | 43 | ||
| Nerve conduction integrity | 43 | ||
| Nerve mechanosensitivity | 44 | ||
| Cervical spine-related nerve conditions | 44 | ||
| Degenerative cervical myelopathy | 44 | ||
| Cervicobrachial disorders and cervical radiculopathy | 45 | ||
| Occipital neuralgia | 46 | ||
| Thoracic outlet syndrome | 46 | ||
| Conclusion | 47 | ||
| References | 47 | ||
| 5 Neuromuscular Disturbances in Neck Pain Disorders | 51 | ||
| Anatomical considerations | 52 | ||
| Changes in motor output in people with neck pain | 53 | ||
| Changes in the coordination between muscles | 54 | ||
| Subtle variations in the distribution of activity within muscles | 57 | ||
| Changes in the temporal characteristics of neck muscle activity | 58 | ||
| Delayed onset of neck muscle activity | 58 | ||
| Delayed offset of muscle activity | 58 | ||
| Individual variability in motor adaptations to pain | 59 | ||
| Changes in peripheral properties of neck muscles | 61 | ||
| Time course for development of neuromuscular dysfunction | 61 | ||
| Implications for management | 62 | ||
| Variability in symptomatic response to exercise | 63 | ||
| Neuromuscular adaptations to exercise | 64 | ||
| Conclusion | 65 | ||
| References | 65 | ||
| 6 Sensorimotor Control Disturbances in Neck Pain Disorders | 71 | ||
| Cervical mechanoreceptors | 71 | ||
| Morphology | 71 | ||
| Central connections | 71 | ||
| Reflex-mediated activity | 72 | ||
| Artificial disturbance to cervical somatosensory input | 73 | ||
| Mechanisms underlying disturbances in sensorimotor control | 73 | ||
| Possible causes of altered cervical afferent input | 73 | ||
| Symptoms of altered cervical sensorimotor control | 74 | ||
| Signs of altered cervical sensorimotor control | 74 | ||
| Cervical proprioception | 75 | ||
| Cervical joint position sense | 75 | ||
| Cervical movement sense or accuracy | 75 | ||
| Cervical force sense | 75 | ||
| Kinematic disturbances | 75 | ||
| Vertical perception | 75 | ||
| Sensorimotor incongruence | 75 | ||
| Postural stability | 76 | ||
| Static measures | 76 | ||
| Dynamic and functional tasks | 77 | ||
| Eye movement control | 77 | ||
| Smooth pursuit neck torsion | 78 | ||
| Coordination | 78 | ||
| Eye-head coordination | 78 | ||
| Trunk-head coordination | 78 | ||
| Onset of disturbances in sensorimotor control | 78 | ||
| Relationships between sensorimotor measures | 79 | ||
| Conclusion | 79 | ||
| References | 80 | ||
| 7 Psychological and Social Considerations in Neck Pain Disorders | 87 | ||
| Psychological features | 87 | ||
| Depression | 88 | ||
| Stress and anxiety | 88 | ||
| Catastrophization | 88 | ||
| Fear avoidance | 88 | ||
| Patient expectations | 89 | ||
| Self-efficacy | 89 | ||
| Implications for assessment and management of psychological features | 89 | ||
| Social features–the work environment | 90 | ||
| The changing face of work | 90 | ||
| Workplace psychosocial factors and the development of neck pain | 92 | ||
| Biological associates of work-related social and psychological factors | 92 | ||
| Return to work | 93 | ||
| Conclusion | 93 | ||
| References | 94 | ||
| 3 Clinical Assessment | 99 | ||
| 8 Clinical Assessment | 101 | ||
| Elements of the patient interview | 101 | ||
| Outcomes of the patient interview | 101 | ||
| The patient-clinician rapport and collaborative relationship | 102 | ||
| Musculoskeletal disorder recognition | 102 | ||
| Red flag recognition | 102 | ||
| Conditions requiring caution | 103 | ||
| Provisional decision on pain mechanism(s) | 103 | ||
| Provisional decision on other symptoms | 104 | ||
| Sensorimotor disturbances | 104 | ||
| Sleep | 104 | ||
| Knowledge of physical provocative factors and functional limitations | 104 | ||
| Knowledge of psychological or social moderators | 105 | ||
| Provisional diagnosis | 106 | ||
| Prognostic features | 107 | ||
| Treatment goals and outcome measures | 107 | ||
| Conclusion | 108 | ||
| References | 108 | ||
| 9 Clinical Assessment | 111 | ||
| Analysis of provocative movement or posture | 112 | ||
| Analysis of posture | 112 | ||
| Control of scapular posture | 115 | ||
| Adjacent regions | 116 | ||
| Analysis of cervical motion | 116 | ||
| Assessment of cardinal planes of motion | 116 | ||
| Cervical and craniocervical motion | 117 | ||
| Cervical flexion. | 117 | ||
| Cervical extension. | 117 | ||
| Craniocervical flexion and extension. | 118 | ||
| Craniocervical and cervical lateral flexion. | 118 | ||
| Craniocervical and cervical rotation. | 118 | ||
| Movement speed and velocity profile | 118 | ||
| Cervicothoracic region | 119 | ||
| Cervicothoracic flexion and extension. | 119 | ||
| Cervicothoracic rotation and lateral flexion. | 119 | ||
| Movement tests to further direct management | 119 | ||
| Movement diagnostic tests | 120 | ||
| Cervical flexion rotation test. | 120 | ||
| Extension rotation test, manual segmental examination, palpation of segmental tenderness. | 120 | ||
| Spurling’s test. | 120 | ||
| Positional tests for vertebral artery insufficiency | 120 | ||
| Sensory testing and pain mechanisms | 121 | ||
| Examination of the nervous system | 121 | ||
| Clinical neurological examination | 121 | ||
| Tests of nerve mechanosensitivity | 122 | ||
| Neurodynamic tests | 122 | ||
| Nerve palpation | 123 | ||
| Manual examination | 123 | ||
| Instability tests | 126 | ||
| Assessment of the neuromuscular system | 128 | ||
| Scapular muscle tests | 128 | ||
| Scapular holding test (lower trapezius) | 128 | ||
| Reassessment of cervical posteroanterior glides | 128 | ||
| Trapezius muscle tests | 129 | ||
| Serratus anterior test | 129 | ||
| Axioscapular muscle length tests | 130 | ||
| Craniocervical flexion test | 130 | ||
| Preparation for the test | 130 | ||
| Formal test procedure | 131 | ||
| Stage 1. | 131 | ||
| Stage 2. | 132 | ||
| Cervical flexor strength and endurance | 132 | ||
| Cervical extensor muscle tests | 132 | ||
| Suboccipital muscles | 133 | ||
| Cervical extensors | 134 | ||
| Cervical extensor strength and endurance | 135 | ||
| Assessment of disturbances in sensorimotor control | 135 | ||
| Cervical proprioception | 135 | ||
| Cervical position sense | 135 | ||
| Cervical movement sense | 136 | ||
| Standing balance | 137 | ||
| Oculomotor assessment | 138 | ||
| Gaze stability | 138 | ||
| Eye follow: smooth pursuit neck torsion test | 138 | ||
| Eye-head coordination; trunk-head coordination | 138 | ||
| Other causes of disturbances to the sensorimotor control system | 140 | ||
| Conclusion | 141 | ||
| References | 141 | ||
| 10 The Differential Diagnosis of Symptoms and Signs of Sensorimotor Control Disturbances | 149 | ||
| Differential diagnosis of dizziness | 149 | ||
| Central vestibular disorders | 150 | ||
| Cervical vascular disorders | 150 | ||
| Minor brain injury | 151 | ||
| Vestibular migraine | 151 | ||
| Peripheral vestibular lesions | 151 | ||
| Benign paroxysmal positional vertigo | 151 | ||
| Perilymph fistula | 152 | ||
| Ménière disease | 152 | ||
| Labyrinthitis and vestibular neuronitis | 152 | ||
| Acoustic neuroma | 152 | ||
| Differential diagnosis of other symptoms | 152 | ||
| Visual system disturbances | 152 | ||
| Tinnitus | 152 | ||
| Clinical examination | 152 | ||
| History and interview | 153 | ||
| Symptom differentiation | 153 | ||
| Physical assessment | 153 | ||
| Cervical musculoskeletal examination | 153 | ||
| Cervical sensorimotor examination | 156 | ||
| Neck torsion versus en-bloc trunk torsion | 156 | ||
| Vestibular and visual tests | 156 | ||
| Conclusion | 157 | ||
| References | 157 | ||
| 11 Headache | 161 | ||
| Neck pain and headache | 161 | ||
| What defines cervical musculoskeletal dysfunction? | 163 | ||
| Articular system | 163 | ||
| Neuromuscular system | 164 | ||
| Posture | 164 | ||
| Neural system | 165 | ||
| Sensorimotor dysfunction | 165 | ||
| Cervical musculoskeletal dysfunction defined | 165 | ||
| Cervical musculoskeletal dysfunction in headache: clinical decisions | 165 | ||
| Conclusion | 166 | ||
| References | 167 | ||
| 4 Clinical Management | 171 | ||
| 12 Principles of Management | 173 | ||
| Selection of management strategies | 174 | ||
| Clinical practice guidelines | 174 | ||
| Clinical prediction rules | 175 | ||
| Subgrouping | 175 | ||
| Selection of interventions | 176 | ||
| Conclusion | 177 | ||
| References | 178 | ||
| 13 Communication, Education and Self-Management | 181 | ||
| Communication | 181 | ||
| Listening | 181 | ||
| Language | 182 | ||
| Communication through touch | 182 | ||
| Education | 183 | ||
| Education on the neck pain disorder | 183 | ||
| Education in anatomy and biomechanics | 184 | ||
| Education and use of behavioural strategies | 184 | ||
| Self-Management | 185 | ||
| References | 185 | ||
| 14 Management of Joint and Movement Dysfunction | 189 | ||
| Manipulative therapy | 189 | ||
| Benefits of manipulative therapy | 189 | ||
| What manipulative therapy cannot achieve | 191 | ||
| Patients suitable for manipulative therapy | 191 | ||
| Contraindications and cautions to manipulative therapy | 192 | ||
| Which manipulative therapy approach? | 193 | ||
| Selection and application of technique | 193 | ||
| Treatment of the cervical spine for pain in adjacent areas | 195 | ||
| Active exercise | 195 | ||
| Range of motion | 195 | ||
| Exercises for training movement velocity and accuracy | 196 | ||
| Self-management | 196 | ||
| Conclusion | 197 | ||
| References | 197 | ||
| 15 Management of Neuromuscular Dysfunction | 201 | ||
| Exercise adherence | 202 | ||
| The home program | 203 | ||
| Neuromuscular training | 203 | ||
| Posture training | 204 | ||
| Spinal posture | 204 | ||
| Scapular posture | 205 | ||
| Head and neck posture | 206 | ||
| Training the activation and endurance of the deep cervical and axioscapular muscles | 206 | ||
| Cervical flexor training | 206 | ||
| Training the craniocervical movement pattern | 207 | ||
| Training the endurance of the deep cervical flexors | 207 | ||
| Cervical extensor training | 208 | ||
| Craniocervical extensors | 209 | ||
| Craniocervical rotators | 209 | ||
| Deep cervical extensors | 209 | ||
| Scapular muscle training | 210 | ||
| Training muscle control and coordination in movement and postural tasks | 212 | ||
| Training the cervical flexor and extensor muscles | 212 | ||
| Training coactivation | 212 | ||
| Training control and coordination between deep and superficial neck flexors | 212 | ||
| Training scapular control with arm movement and light load | 213 | ||
| Training muscle endurance and strength | 213 | ||
| Neck flexors | 213 | ||
| Neck extensors | 214 | ||
| Training scapular muscle endurance and strength | 215 | ||
| Dosage and intervention timelines | 215 | ||
| Maintenance program | 216 | ||
| Relapse prevention | 217 | ||
| Conclusion | 217 | ||
| References | 217 | ||
| 16 Management of Sensorimotor Control Disturbances | 221 | ||
| Approaches to management | 221 | ||
| Addressing the cervical musculoskeletal pain and dysfunction | 221 | ||
| Addressing the adaptive changes in the sensorimotor control system | 222 | ||
| Combining cervical musculoskeletal and sensorimotor approaches | 222 | ||
| Principles for tailored sensorimotor control exercises | 223 | ||
| Exercises to train sensorimotor control | 223 | ||
| Training cervical joint position sense | 223 | ||
| Retraining cervical movement sense | 224 | ||
| Smooth-pursuit eye-movement exercises | 225 | ||
| Gaze stability exercises | 225 | ||
| Eye-head coordination exercises | 225 | ||
| Trunk head coordination exercises | 226 | ||
| Static balance training | 227 | ||
| Functional, dynamic balance training | 227 | ||
| Vestibular rehabilitation and vision therapy | 227 | ||
| Psychological considerations | 228 | ||
| Self-management | 228 | ||
| Conclusion | 228 | ||
| References | 228 | ||
| 17 Management of Nerve Tissue | 231 | ||
| Neurophysiological mechanisms underpinning nerve tissue management | 231 | ||
| Restoring homeostasis around the nerve | 231 | ||
| Restoring homeostasis within the nerve | 232 | ||
| Restoring tolerance to motion and resolving mechanosensitivity | 232 | ||
| Matching management to the nature of the nerve-related condition | 232 | ||
| Patient education and advice | 233 | ||
| Addressing contributing factors | 233 | ||
| Postural/movement–based strain to nerve | 233 | ||
| Ergonomic factors and nerve strain | 234 | ||
| Manual therapy | 234 | ||
| Manual techniques directed at nerve mechanosensitivity | 234 | ||
| Manual techniques for altered nerve conduction | 235 | ||
| Self-mobilization with home exercise | 235 | ||
| Referral to medical physicians | 236 | ||
| Conclusion | 236 | ||
| References | 237 | ||
| 18 Case Presentations | 241 | ||
| Case 1: Directionally biased persistent neck pain (Fig. 18.1) | 241 | ||
| Patient presentation and key examination findings | 241 | ||
| Reported aggravating factors and functional examination | 241 | ||
| Other examination findings | 242 | ||
| Diagnosis and clinical reasoning | 242 | ||
| Management approach | 242 | ||
| Advice and education | 242 | ||
| Exercise therapy | 243 | ||
| Reflection and clinical message | 243 | ||
| Case 2: Headache—differentiating the role of the neck (Fig. 18.2) | 243 | ||
| Patient presentation | 244 | ||
| Index | 263 | ||
| A | 263 | ||
| B | 263 | ||
| C | 263 | ||
| D | 264 | ||
| E | 265 | ||
| F | 265 | ||
| G | 265 | ||
| H | 265 | ||
| I | 265 | ||
| J | 265 | ||
| K | 265 | ||
| L | 265 | ||
| M | 266 | ||
| N | 266 | ||
| O | 268 | ||
| P | 268 | ||
| Q | 269 | ||
| R | 269 | ||
| S | 269 | ||
| T | 270 | ||
| U | 270 | ||
| V | 270 | ||
| W | 270 | ||
| X | 270 | ||
| Z | 270 |