5 THINGS I LOOK FOR IN PATIENTS WITH NECK PAIN

5 THINGS I LOOK FOR IN PATIENTS WITH NECK PAIN

I have been asked by many students in the past: What are the first things I look for when I see someone complaining of neck pain? One of the best Shoulder and Neck Therapists I've ever trained under is Cliff Fowler who was a Canadian Physiotherapist and he said when you don't have much time in the clinic to see patients, the best way to manage your time is to do this principle during your Evaluation: Find it, fiddle with it, fix it. I have to say, those words have served me well.

There are five specific things I look first and then I start from there.

1. POSTURE AND THORACIC SPINE. This truly is the first one I look for. From their posture while sitting in the waiting room to their posture when they see me come get them, to the posture that they project when they sit on my treatment table. There are tons of researches out there that relate thoracic issues with neck and shoulder issues. I also specifically screen the ribs as well.

2. SHOULDERS. These should NEVER be overlooked. If you were the patient, always tell your therapist if there's anything bothering your shoulder. If I was the treating therapist, I always ask if the shoulder has started to hurt as well and I include that in the screening.

3. HOME and WORK RELATED ACTIVITIES. I've treated some front-desk / receptionist workers who come to me complaining of a one sided neck pain e.g., turning the head to the right bothers them. I definitely ask them if there is a certain area in the work place where they turn their head a lot all the time. Sometimes it is as simple as workspace modification that solves the problem.

4. EXERCISE. Multiple studies have shown that exercise improves neck pain. Also ask if overhead exercises bother their necks.Studies have shown the Therapeutic exercises coupled with manual therapy done by a Physical Therapist will produce greater relief than either exercise alone or manual therapy alone.

5. COMPLIANCE. I know this sounds a bit different than what you've expected but compliance is of utmost importance. I check these after 2-3 visits with me and I check how compliant they were with doing the specific exercises on their own. Did they follow through as planned and instructed? Did they overdo things? Did life just happen and they fell off the wagon of doing their homework?

In any case, the neck seems to be a more common issue I see in the clinic nowadays and it is not surprising at all because of the advent of what I call: "posture-destroying electronic devices": Smart phones and tablets.

On a related note, do expect to see more and more of my posts related to neck and shoulders in the blogs to come.