Neck pain is a common condition, ranking as the fourth most burdensome disease worldwide. Evidence suggests that rates of recurrence and chronicity are high (Borghouts et al., 1998; Hoving et al., 2001), which results in considerable functional and economic implications (Vos et al., 2012). Joint mobilization (JM) is widely acknowledged as an effective intervention (Childs et al., 2008). However, a Cochrane review indicated that the most effective cervical JM dosage has yet to be determined (Gross et al., 2010). Multiple studies have established a sympatho-excitatory effect resulting from cervical JM (McGuiness et al., 1997; Vicenzino et al., 1998; La Touche et al., 2013). On the contrary, Yung et al. (2014) developed a distinctive dose using anterior-to-posterior pressures (AP) of the cervical spine that resulted in a reduction in systolic blood pressure (SBP) and heart rate (HR), suggesting a sympatho-inhibitory effect. Therefore, it is indeterminate whether cervical JM results in sympatho-excitatory or sympatho-inhibitory effect if the dosage (Yung et al., 2015) is different from the traditional 3 sets of continuous 30-90 second regimen.
Maitland’s (Maitland et al., 2005) unilateral posterior-to-anterior glide (PA) is an entry-level form of JM commonly used by physiotherapists worldwide; and it appears to be more efficacious for pain relief and outcomes in patients with unilateral neck pain compared to other JM techniques such as transverse pressures and cervical
Clinical Topics: ACOEM Pain, Suffering, and the Restoration of Function Chapter guidelines stress the importance of a time-limited treatment plan with clearly defined functional goals, with frequent assessment and modification of the treatment plan based upon the patient’s progress in meeting those goals, and monitoring from the treating physician is paramount. In addition, CA MTUS Acupuncture Medical Treatment Guidelines state that acupuncture can be used to reduce pain, reduce inflammation, increase blood flow, increase range of motion, decrease the side effect of medication-induced nausea, promote relaxation in an anxious patient, and reduce muscle spasm. Furthermore, guidelines state that time to produce functional improvement of 3 – 6 treatments. The patient has chronic neck pain. The latest progress report indicated that the pain is rated 9/10-scale level. Medications and PT have been tried and provided minimal improvement is her pain. The guidelines support 3 to 6 treatments of acupuncture to produce functional improvement. In addition, the latest progress report discussed about continued acupuncture 2X4. It is unclear if the patient has received acupuncture treatment for the cervical spine before. If yes; number of sessions completed to date, functional improvement and pain relief from the prior treatment should be documented. Additional information is required to certify the request. Recommend
Frequent deployments and changing times created a distraction in the Professional aspect of the Army. The distraction created a deficiency in maintaining the highest standards of the Profession of Arms. In an effort to refine their understanding of the Army Profession, the Secretary of the Army and the Army Chief of Staff directed that a review of the Army Profession be conducted, thus the creation of the Profession of Arms Campaign.
Because yoga is a practice that inherently stretches and strengthens muscles and improves posture, it is one your physical therapist may recommend. Yoga International says that the postural awareness yoga practice fosters is effective for lasting relief from a pain in your neck, and offers a few suggestions for yoga poses for neck pain that can be done while sitting in a chair.
Using a randomized controlled trial, they divide their 61 participants into either a cupping treatment group or a progressive muscle relaxation group. Unlike the previous study by Lauche et al. 2011, the current study participants received cupping treatment group treatment twice per week for a maximum of 15 minutes during the 12 weeks rather than just 1 treatment. The progressive muscle relaxation group were instructed to perform abbreviated or less complex techniques for neck pain. Participants were to perform the progressive muscle techniques twice per week for a maximum of 20 minutes. Both treatment groups after each treatment as to record their level pain using a 100mm visual analog scale, daily pain, their expectation of the success of the treatment, and any negative effects.
Cervical Traction (Parameters): Acute/ 1st session- 6 to 10 lbs., static pull, 5 minutes, gradually increase to patient tolerance. Routine Session- 20 to 30 lbs. or 7% of the patient’s body weight, intermittent pull- 15/15, Time: 20 minute. This treatment will distract the joints in the cervical region and help alleviate the pain.
Carey reported that she experienced occasional numbness of the upper extremities and that she would occasionally drop objects from both hands. Upon physical examination, Dr. Abiera noted that Ms. Carey’s range of motion of the cervical spine was decreased on flexion and tenderness on palpation of posterior cervical muscles with spasms and trigger points was present. In addition, Dr. Abiera noted that the range of motion of lumbar spine was within normal range, however there was still some tenderness on palpation of thoracic paraspinals muscles.
A physician with a wealth of experience in the fields of anesthesiology and pain management, Dr. Daniel Kendall has served as an interventional pain medicine specialist with National Spine and Pain Centers for 17 years. He treats patients out of National Spine and Pain’s Arlington location near his home town of Vienna, Virginia. Before assuming his current position, Dr. Daniel Kendall served as chief fellow of pain management at Johns Hopkins Hospital in Baltimore, Maryland. His experience with Johns Hopkins included training in advanced modalities such as sympathetic blocks, vertebroplasty, intrathecal pumps, IDET, radiofrequency ablation, and spinal cord stimulation.
The Second World War was one of the most terrifying events in the world’s history. The U.S.A fights back like never before against Italy, Japan and Germany. Previously the WWII by the 1930’s America was completely poor and lost. By entering in the War, The U.S. becomes a superpower in just four years. The disruption of World War II arouses the mobilization of American industrial and in the military section. The preparation for the battle and the mobilization of the War was a complete success; purpose and determination led the U.S.A to win the WWII.
The patient was compliant to all aspects of treatment and the home exercise program. There are no known alternate explanations of the outcomes of this case report. However, in comparison to the case report by Caldwell et al25., the patient in this case report displayed a faster decrease in pain and return to normal function indicated by 0/10 VAS, 0% neck disability and ability to perform all tasks for work at the last day of treatment, 3 weeks from the first day of physical therapy. Possible explanations for the faster recovery could be due to the slight difference of impairments as well as the addition to grade IV and V manipulations to the cervical and thoracic spine as suggested to have high correlation with decrease in pain and normalization
We are grateful for the “Manual Therapy” reviewers thoughtful review and suggestions to improve our manuscript. Our author team has reviewed, considered, and responded to all comments and suggestions the reviewers proposed in accordance with “Manual Therapy” guidelines. Thus, we are submitting a revised manuscript “The Immediate Cardiovascular Response to Joint Mobilization of the Neck- A Randomized, Placebo-Controlled Trial in Pain-Free Adults” for follow-up consideration for publication in “Manual Therapy”. We are hopeful that our work will be deemed as valuable and disseminated for other manual therapists to consider.
Webster defines sustainment as “The act of sustaining; maintenance; support”. ADRP 4.0 states that the endurance of the Army forces is primarily the function of their sustainment. Sustainment determines the depth and duration of Army operations. All over Army doctrine you will see references to sustainment. It is critical to any Army operation no matter how small and simple to large and complex. If leaders do not think about or are afforded the opportunity to plan and coordinate sustainment operations into their task, then the outcome could be devastating. Inadequate sustainment planning not only devastates the mission, but also the soldiers, citizens, equipment and habitat involved. One would think that for sustainment to be successful
The army... when you think about the army what do you think of? The army is a key member of a joint defense company, dominant across the full spectrum of operation. The Army provides the Joint Force with the campaign-quality combat, combat support, and combat service support capabilities necessary to conduct sustained land warfare; this is the unique contribution to the Joint Team and it will be maintained. The Army must always be ready to defend the United States and its territories; support national policies and objectives; and defeat adversaries responsible for aggression that endangers the peace and security of the United States and our allies.
Trigger point injection (TPI) with a local anesthetic with or without steroid may be recommended for the treatment of chronic neck pain with myofascial pain syndrome (MPS) when all of the following criteria are met:
Neck pain is a common condition, ranking as the fourth most burdensome disease worldwide. Evidence suggests that rates of recurrence and chronicity are high (Borghouts et al, 1998; Hoving et al, 2001), which results in considerable functional and economic implications (Vos et al., 2010). Joint mobilization (JM) is widely acknowledged as an effective intervention (Childs et al., 2008); and the UPA is an entry-level form of JM commonly used by physiotherapists globally. However, a Cochrane review indicated that the most effective cervical JM dosage has yet to be determined (Gross et al., 2010). Unilateral anterior glide (UPA) appears to be more efficacious for pain relief and outcomes in patients with unilateral neck pain compared to other JM techniques (Egwu, 2008). The rationale behind the pain modulation attained with JM has been suggested to be as a result of neurophysiologic mechanisms (Bialosky et al., 2008). For example, spinal manipulative therapy has been associated with increased afferent discharge (Colloca et al., 2003), motoneuron pool depression (Dishman et al., 2005), changes in motor activity (Herzog, 1999; DeVocht, 2005) and reduction of pain perception in response to a standard stimulus (George, 2006; Vicenzino, 1996). The neurophysiologic system that alters pain overlaps with blood pressure (BP) as observed in BP-related hypoalgesia (Vincenzino, 1998; Sterling, 2001). Therefore, BP is a pertinent and easily quantified variable to examine to ensure
This trial had randomly selected 119 patients with neck pain associated with ‘active trigger points’. The patients aged between 30 and 60 years old. The results proved that myofascial release was beneficial especially when combined with heat therapy. (Hou, Tsai, Cheng, Chung & Hong, 2002). The Physiotherapy department, Health Sciences School, University of Granada, Spain (2008) conducted a randomized clinical trial which supported the effectiveness of myofascial release. The effects of this technique when applied after high-intensity exercise, were examined and recorded with 62 randomly selected people. The results concluded that the treatment was beneficial for the recovery of the heart rate variability (HRV) and diastolic blood pressure (BP) (Arroyo-Morales et al., 2008). However, it is difficult to apply these findings to clinical situations because the mean age used for this experiment was 21.1 ± 2.16 years. A larger age group is required to apply to general