flash cards - c:sp and TH:sp.pdf

Cervicogenic Headache Treatments Info Education Headache results from C/Sp (referral pain) - Pain may radiate to forehead, ‘Your next p...

Cervicogenic Headache Treatments Info Education Headache results from C/Sp (referral pain) - Pain may radiate to forehead, ‘Your next posture is your best posture’ orbital region, temples or ears, most unilateral Address provocative postures, posture cues, ergonomics Decreased or limited cervical ROM - C1-3 share same nerve supply as Scap depression, Forward head posture, AA muscle use occipital area Cold or hot pack Positional or associated with particular movement Cervical pillow/supportive mattress Very consistent and specific sx during ax Traction and stretching Duration: couple hours during aggravating activity Stress management and relaxation therapy, posture and ergonomic Assessment evaluation Pain reproduced with overpressure over aJected upper cervical area Prognosis: complete recover expected in most cases, but underlying Multiple upper cervical joint restrictions or dysfunctions chronic conditions prognosis is guarded Craniocervical flexion test (CCT) distinguish cranio vs migraine and/or PAIVMs ® improve joint mobility and decrease pain tension (these two won’t have ¯ in function/strength during test) – balloon C0-3 à unilateral PA, transverse glide (­ rot) cuJ one Cervical Flexion Rotation Test (CFRT) - Norm = 45 deg each direction. Exercise Cervico would be expecting decrease 15 deg or diJerence of 10+ deg L to Give self an upper cut isom (flex) R 4pt kneeling pushup (ext) PAIVMs for C0-3 unilat PA - Hypomobility, pain reproduction, diJerent comparing sides. Other types of headaches will be more diJuse sx, less specific, just report soreness Non-Specific neck pain Treatment Info Education Neck pain with no specific cause Advice to stay active, prognosis info, reassurance, self-management Resolves on its own in a few days or weeks strategies Factors that could contribute Work related neck pain ® work environment, ergonomics, postural o Physical strain at work Exercise o Emotional stress Restore neuromuscular control of deep neck flexors ® pain and disability Not dangerous ® best to stay active Double chins Assessment Give self an upper cut isom ROM with OP 4pt kneeling pushup o F: reach chin to chest? – gap between Bow and arrow for T/SP o E: sternal notch to chin Mobilisations o Rot: chin to acromion Central PA, unilat PA and Transverse glide, cervical distraction o LF: ear to acromion Mulligans à rotation MWM, MVM flexion o Cranio-cervical flexion STM o Cranio-cervical extension Trigger point ant scalene, upper traps, suboccipital o Cranio-cervical rotation Combined movements Other o Ext + Rot, Ext + LF, F + LF, F + Rot Neuro screening PAIVMs ® central PA, unilat PA, transverse For work related neck pain ® functional movements related to job  Neuro screening for C/sp If any neurological symptoms are present VBI ® Vestibular Basilar Insu?iciency Assessment Info 5D’s, 3N’s ® dizziness, diplopia, dysphagia, dysarthria, drop Insu%icient blood supply to the brain due to disruption to blood flow supplied attacks, numbness, nausea, nystagmus by the carotid or vertebral artery If yes, move onto next step Symptoms o Vertigo, dizziness, unsteadiness and giddiness Consent for VBI test ® The consent process must include an o Headache or neck pain that is ‘worse or di%erent to what they have had explanation of benefits, risks, alternatives, and an opportunity before’ to ask questions. o Other possible symptoms § Visual disturbance Rotation only for 10-15 sec = (Sn 0-0.57 Sp 0.67-1) – good rule § Facial numbness or paraesthesia in. (If already symptomatic, don’t add Ext version). Combine E § Dysphagia, dysarthria, hoars and rotation to compress artery. Test other side. § Drop attacks § Hemiparesis Prognosis: Aortic dissection and vertigo (BPPV) are the 2 other things that have o Chance of death box, deltoid tuberosity patients should see an improvement of symptoms in a few weeks, for some Neurodynamic test it may be months Myotomes/sensation/reflexes Non-specific thoracic spine pain Treatments Info Exercise Patient often complains of pain in and around the scap ® could be central, Cat/Cow unilateral or bilateral Stretch pec Can result of sudden movement or gradual onset Scapular retractions, rows PAVIMs Assessments Active movements (SOEOB) ® Flexion, extension, rotation, lateral flexion ®+ OP Combined movements ® Flexion + rotation. Extension + rotation. Any other functionally reported movement (below) Other functional movements tests ® Unilateral bicep curl, Wall push up, Single leg stance/single leg squat, Prone arm lift, 4-point kneeling, Sitting reposition test, Inspiration PAVIMs ® Unilateral PA (transverse process), central PA (spinous process), PA costo-transverse and costovertebral joint (indirectly). PPIVMs ® Flexion, extension, rotation - To find spinous processes ® finger rule - 21-22-43-22-21 (T1-T12)