Learning Zone

This lecture is based around the recent publication of the IFOMPT Cervical Framework for Vascular Pathologies of the Neck. Safety of patients has always been an urgent concern of all therapists. For decades, the wide-use of manual techniques for cranio-cervical dysfunction has been associated with serious neuro-vascular adverse events, e.g. stroke. This concern has impacted on our practice in many ways, from developing testing and screening methods, through to the wholesale avoidance of therapeutic interventions. In this lecture I will draw on the best of evidence to understand how to consider, assess, and manage risk for people with head and/or neck pain.  I claim that we have made some errors of thinking in the past decades which has led us from the real issues at hand; thus delaying a more reasoned, scientific approach to assessment of risk. A clinical reasoning framework which facilitates identification of vascular pathology in people presenting with head and neck pain will be presented. This supersedes previous guidance which seeks to 'screen' for at risk patients. The key outcomes of the lecture are to understand and implement a more evidence base risk assessment strategy for people seeking treatment for their head and/or neck pain.