Learning Resources

Clinical Flowchart – Cervical Pain

Cervical Pain Flowchart

Clinical reasoning & physiotherapy approach

Clinical Reasoning: Cervical Pain Presenting Complaint Neck pain ± stiffness, headache, radiating arm pain ↓ ROM, functional limitation ⚠️ RED FLAGS? Neurological deficit, myelopathy signs, trauma, malignancy, infection If YES → urgent referral / imaging Initial Observations Posture, ROM, pain severity, vital signs Screen for neurological involvement Subjective Assessment Onset (gradual/acute), mechanism of injury Pain distribution, aggravating/relieving factors Occupational / ergonomic history Prior treatment & patient goals Objective Assessment Inspection: alignment, deformity Palpation: tenderness, spasm ROM testing • Neurological screen (strength, reflex, sensation) Special tests: Spurling’s, distraction Clinical Interpretation Mechanical neck pain / radiculopathy / muscular strain Consider psychosocial factors Physiotherapy Management Education: posture, ergonomics, activity modification Manual therapy • Soft tissue release • Gentle mobilisation Exercises: ROM, strengthening, endurance Pain relief: heat/ice, TENS if available Refer if progression or neurological deficits appear SMART Goals & Review ↓ pain • ↑ cervical ROM • Return to normal activity Functional tolerance improved Regular reassessment & adjust plan Improving Continue plan Progress exercises Not Improving Reassess • Investigate further Consider referral