Cervical arterial dysfunction: knowledge and reasoning for manual physical therapists
Five articles on PainSci cite Kerry 2009: 1. The Complete Guide to Chronic Tension Headaches 2. The Complete Guide to Neck Pain & Cricks 3. What Happened To My Barber? 4. Does Spinal Manipulation Work? 5. When to Worry About Neck Pain … and when not to!
PainSci notes on Kerry 2009:
A discussion of the clinical challenge of cervical artery dissection that presents with pain as the only symptom.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
SYNOPSIS: This clinical commentary provides evidence-based information regarding adverse cerebrovascular events in the context of manual therapy assessment and management of the cervical spine. Its aim is to facilitate clinical decision making during diagnosis and treatment of patients presenting to the therapist with cervicocranial pain. Rather than focusing on a traditional view of premanipulative testing as the cornerstone for decision making, we present information concerning the clinical presentation of specific vascular conditions. Additionally, we discuss the assessment and management of musculoskeletal pain in the presence of risk factors for cerebrovascular accident. It is proposed that vascular "red flag" presentations mimic neuromusculoskeletal cervicocranial syndromes. Invariably, the 2 conditions coexist. This reasoning presupposes that some patients who have poor clinical outcomes, or a serious adverse response to treatment, may be those who actually present with undiagnosed vascular pathology. We use 2 case reports to demonstrate how incorporating vascular knowledge into clinical reasoning processes may influence clinical decision making.
related content
- “Spontaneous cervicocephalic arterial dissection with headache and neck pain as the only symptom,” Hajime Maruyama, Harumitsu Nagoya, Yuji Kato, Ichiro Deguchi, Takuya Fukuoka, Yasuko Ohe, Yohsuke Horiuchi, Tomohisa Dembo, Akira Uchino, and Norio Tanahashi, J Headache Pain, 2012.
- “Pain as the only symptom of cervical artery dissection,” M Arnold, R Cumurciuc, C Stapf, P Favrole, K Berthet, and M-G Bousser, J Neurol Neurosurg Psychiatry, 2006.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
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- Photobiomodulation therapy is not better than placebo in patients with chronic nonspecific low back pain: a randomised placebo-controlled trial. Guimarães 2021 Pain.
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- The CANBACK trial: a randomised, controlled clinical trial of oral cannabidiol for people presenting to the emergency department with acute low back pain. Bebee 2021 Med J Aust.
- Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects. Gerhart 2017 Ann Behav Med.