Overview of Cervical Spine Assessment
Original Editor - Jacquie Kieck based on the course by
Top Contributors - Jacquie Kieck, Jess Bell and Kim Jackson
Introduction[edit | edit source]
A thorough assessment is vital for the effective management of any condition. The cervical spine is no different. In this course Shala Cunningham gives a step-by-step overview of the vital elements of a thorough assessment of the cervical spine. The assessment should broadly consist of a subjective (history taking) and objective assessment (observation and tests). A thorough assessment allows the clinician to classify the client's presentation. A classification system is discussed below to guide the clinician in the effective management of the client.
Subjective Assessment[edit | edit source]
History[edit | edit source]
In this course the instructor suggests using the mnemonic LMNOPQRST to cover all the aspects of the history taking in the subjective assessment.
L: Location of symptoms and Level of functional impairment
Area of Symptoms | Possible Source of Symptoms | ||
Head/occipital region | Upper cervical spine | ||
Localised pain without radiation/referral | Muscle pain
Facet pain Facet impingement |
||
Radiating pain | Nerve root irritation |
M: Medical factors (Medications) and Mechanism of injury
Be specific in finding out when and how the injury occurred, what forces were applied, and the position of the head at the time of the trauma. Also ask about neurological symptoms with the trauma. Red flags would be sudden onset, severe pain with no incident or accident.
N: Neurological symptoms
Establish if there are symtoms of numbness, tingling, burning or electrifying. Be
Be specific about the location of these symptoms i.e. are they dermatomal? Also to note if the symptoms are constant or intermittent and if they are associated with the position of the head.
O: Occupation including limitations
P: Palliating and Provocating symptoms
What increases and decreases the symptoms, also note how long it takes the symptoms to calm down once aggravated. Red flag would be constant/unrelenting pain.
Q: Quality of symptoms/pain
This would cover the description of the symptoms for example, sharp, dull, stabbing, aching or electric/shock-like
R: Radiation of symptoms
Be specific about where the symptoms radiate to, how long do the radiating symptoms last and are they constant or position/activity related. Red flag would be multiple dermatomes.
S: Severity of symptoms
Note how the symptoms impact function and activity. Red flag
T: Timing of symptoms
Ask about the sequence and progression of symptoms. Red flags would be if pain is interrupting sleep, or constant/unrelenting pain.
Additionally one should also include questions about:
Age
Past history of neck pain
Constitutional symptoms
dizziness, drop attacks and vertigo
Other symptoms such as pain, parasthesia, numbness, weakness or stiffness
Objective Assessment[edit | edit source]
Resources[edit | edit source]
- bulleted list
- x
or
- numbered list
- x