Protocol: Neck Pain/Strain/Whiplash

This describes the various treatment procedures the physical therapist may select, as indicated by patient evaluation, re-evaluation, treatment responses.

ACUTE INTERVENTION:

1.         Pain control modalities, as needed and used in concert with restorative procedures to facilitate treatment tolerance and control disabling pain.

                        Ice, heat, electric Stim (Microcurrent, TNS, Neuroprobe, Russian, Interferential).

                        Corrective-protective rest positioning; relaxation training.

2.         Initial patient education on problem, treatment, self-care.

3.         Posture stress correction; daytime, nighttime, workplace, auto

4.         Manual, mechanical, positional traction-distraction

5.         Gentle, remedial low-grade articular and-or soft tissue manual therapy and mobilization

6.         Physician specialty referrals as indicated

SUB-ACUTE RECOVERY:

1.         Exercise progression of range of motion, flexibility, stability, strengthening exercises at                 the neck and related upper body regions (emphasizing home exercises).

2.         Manual therapy progression: articular and soft tissue mobilization: 

                        Cervical, upper thoracic, subcranial, TMJ contributing structures as indicated;

                        Myofascial release, strain counterstrain, craniosacral technique, massage.

3.         Manual, positional, mechanical traction in clinic; home units.

4.         Address contributory stresses at shoulder girdle, upper back, thoracic outlet and TMJ with manual therapies, electrotherapies, corrective exercises

5.         Advanced patient education; risk factor education.

6.         Ergonomic job evaluation and modification; job coaching.

7.         Return-to-work plan; restricted duty recommendations; employer education.

8.         Reconditioning exercise plan; home and gym

Clinic treatment typically 2-3 visits per week for 2-5 weeks

GOALS:         

            Establish self-care skills and participation to minimize dependence on providers

            Safe, early return to work

            Pain control; pain relief

            Reduce inflammation and spasm

            Restore posture, flexibility, mobility, strength at upper body

            Correct derangements, impingements, entrapments

            Restore ADL and occupational functions, tolerances, abilities

            Prevent recurrence.