Musculoskeletaltx

Musculoskeletal Treatment Guidelines

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Cervical Pain

Diagnosis/Definition

Cervical pain that is muscular, discogenic, or arthritic in nature. Patient may be experiencing limited ROM of C-spine or have pain referred to the trapezius or extremity.

Initial Diagnosis and management

History and physical examination.
Radiograph of the spine if cervical pain started with trauma.
MRI/CT not indicated initially.
Initial Management:
NSAIDs.
Adults - 200 to 400 milligrams (mg) every four to six hours as needed for up to 2 weeks. Example: Ibuprofen
Take tablet or capsule forms of these medicines with a full glass (8 ounces) of water.
Do not lie down for about 15 to 30 minutes after taking the medicine. This helps to prevent irritation that may lead to trouble in swallowing.
To lessen stomach upset, these medicines should be taken with food or an antacid.
Do not prescribe muscle relaxants as they are not effective.
Soft collar not recommended except for 1-5 days s/p high speed whiplash trauma (i.e., MVA).
Appropriate activity limitations on lifting, overhead work, heavy headgear, etc.
Ice packs every 20-minute q2h x 72 hours - then change to heat PRN.
Encourage gentle, pain-free ROM.

Ongoing Management and Objective

Should observe a reduction in pain level within 3-5 days.
Chronic upper trapezius tension may persist for up to 2 months.
Expect increased AROM of C-spine and decreased muscle spasm within 2 weeks, complete resolution will take longer.
Indication a Profile is needed
Any limitations that affect strength, range of movement, and efficiency of legs, feet, lower back and pelvic girdle.
Limitations that produce slightly limited mobility of joints, muscular weakness, or other musculo-skeletal defects.
Defects or impairments that require significant restriction of use.

Indication a profile is needed