A-combining cervical manipulation and exercise is more effective for reducing neck pain, HA, and disability than manipulation alone
C- TSM can be used for reducing pain/disability in patients with neck and neck-related arm pain (also some evidence that it is associated with good outcomes in WAD, ROM, and cervical radic)
C- flexibility exercises can be used for patients with neck sx
A- clinicians should consider coordination, strengthening, and endurance exercises in reducing neck pain/HA
C- specifici repeated movements or procedures to promote centralization are not more beneficial in reducing disability when compared to other forms of intervention
B- clinicians should consider the use of Upper quarter and nerve mobilization procedures to reduce pain and disability in patient's with neck/arm pain
B- clinicians should consider use of mechanical, intermittent cervical traction in combination with other interventions such as manual therapy and strengthening exercises, for reducing pain and siability in patients with neck and neck-related arm pain
A- to improve the recovery in patients with WAD, clinicians shoulder educate the patient that early return to normal, non-provocative pre-accident activities is important and also provide reassurance to the patient that good prognosis and full recovery commonly occurs
The central cortex's perception of headaches is first impacted by afferent information coming from the Trigeminocervical nucleus (TCN), which sends pain processing information to the cortex. The TCN receives afferent information from the cervical nerves 1-3 and cranial nerves v, vII, IX, and X that is related to musculoskeletal sources of pain (muscles, ligaments, nerve, and joints) and visceral sources of pain (blood vessels, sinus, minenges, and eyes). The central cortex is able to modify the output of the TCN through efferent pathways through the periaqueductal grey matter, hypothalamus, and locus coerelueus. Heredity, hormones, stress, diet, and sleep disturbance can also modify the information through these outlets and therefore impact the TCN's output.
Pain is eithered perceived or inhibited based on higher center activity from the cortex and brainstem.