Non-specific neck pain: diagnosis and treatment - KCE
Non-specific neck pain: diagnosis and treatment - KCE
Non-specific neck pain: diagnosis and treatment - KCE
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<strong>KCE</strong> reports 119C non-<strong>specific</strong> <strong>neck</strong> <strong>pain</strong> vii<br />
History taking<br />
Excluding red flags<br />
Diagnostic imaging<br />
Proposed intervention(s)<br />
The “Neck Disability Index” as instrument for selfrated<br />
disability<br />
Confirm radiculopathy: Spurling’s test –<br />
traction/<strong>neck</strong> distraction – Shoulder abduction –<br />
Valsalva’s manoeuvre<br />
Rule out radiculopathy: Negative Upper Limb<br />
Tension test<br />
Diagnose facet joint spinal <strong>pain</strong>: Local anaesthetic<br />
block when no clinical <strong>diagnosis</strong><br />
Unfavourable prognostic elements: severe <strong>pain</strong>;<br />
previous attacks; old age or concomitant low back<br />
<strong>pain</strong><br />
Pathologic radiological findings are associated with<br />
worse prognosis<br />
Level of evidence<br />
A, B, C; best available or<br />
no evidence from the<br />
literature<br />
Diagnosis <strong>and</strong> prognosis<br />
No evidence from the<br />
literature<br />
Best available evidence from<br />
the literature<br />
No evidence from the<br />
literature<br />
Level of evidence not<br />
applicable-<br />
Valid instrument<br />
“Strong” or “weak”<br />
<strong>and</strong> “in favour” or<br />
“against”<br />
Strong - In favour<br />
Strong - In favour<br />
Weak - Against<br />
Strong - In favour<br />
C Weak - in favour<br />
C Weak-In favour<br />
C Weak - In favour<br />
C Weak - In favour<br />
C Weak - Against