Learning Zone

Neck pain is a highly prevalent condition that can lead to considerable pain, disability and economic costs. Cervical spine manipulation and mobilisation are frequently used in the management of neck pain and headache. 

Although very rare, serious adverse events following cervical spine treatment have been described in literature. The current hypothesis regarding these serious adverse events is that patients presenting with neck pain and headache who go on to develop a serious adverse event, such as a dissection, have an underlying pathology which is subsequently aggravated by treatment. 

Neck pain, headache, and/or orofacial symptoms are potentially often the first symptoms of an underlying vascular pathology (e.g. craniocervical artery dissection) or blood flow limitation. To identify a underlying vasculogenic contribution, physiotherapists and other musculoskeletal clinicians should have up-to-date knowledge about risk factors, signs and symptoms and should be able to perform a contemporary subjective and objective examination and clinical reasoning process. 

The IFOMPT Cervical Framework guides clinicians to assess the cervical spine for potential vascular pathologies before planning interventions. However, evidence suggests that musculoskeletal clinicians’ knowledge and skills regarding the identification of an underlying vasculogenic contribution to the patient’s complaints can be improved. Therefore, a contemporary approach regarding safe management of people with neck pain and headache will be presented in this IFOMPT webinar.