Neck pain is becoming increasingly common throughout the world and has considerable impact on individuals,their families, communities, health care systems, and businesses. The estimated 1 year incidence of neck pain is 21.3% with a higher incidence noted in female office/computer workers.
Classifying patients with neck pain into subgroups based on specific clinical characteristics and matching these sub groups to specific therapeutic management strategies has been shown to improve patient outcomes. One such clinical characteristic is called Directional Preference (DP).
DP is considered to be present when a patient’s spinal and/or referred spinal pain is decreased in intensity, abolishes, or centralizes, and their spinal range of motion increases in response to a directional specific repeated movement or positional loading strategy.
DP is a common finding in patients who are evaluated by clinicians trained in the use of Mechanical Diagnosis and Therapy (MDT).
MDT is a system that utilizes repeated end range spinal movements and/or static positions to identify specific sub groups of patients with mechanical pain syndromes that readily respond to mechanical therapy exercises and/or manual therapy techniques.
A recent study of 302 neck pain patients undergoing physical therapy demonstrated DP was present in 70% (219) of patients evaluated by physical therapists formally trained in MDT.
Patients with neck pain who demonstrate DP during mechanical testing have better functional outcomes when prescribed treatment in their matched direction of preference. Physical Therapists with formal training in MDT are more likely to identify DP and correctly prescribe treatment in the patient’s matched direction.
At Stover Physical Therapy we specialize in the use of Mechanical Diagnosis and Therapy (MDT) to treat neck pain and a host of other unwanted musculoskeletal problems. Before administering any treatment we always complete a comprehensive history and mechanical evaluation based on MDT principles.
Following the evaluation, we classify the patient’s disorder to aid in the development of an individualized treatment program that commonly includes directionally specific exercises and manual therapy procedures.
We use a validated health questionnaire called the Neck Disability Index (NDI) to monitor our outcomes. The NDI is an instrument specifically developed to assess pain intensity, and assess how neck pain affects activities of daily living. NDI scores vary from 0% -100%, with the lower number representing less pain and disability.
We have compiled the NDI results of 223 patients with neck pain, with and without referred symptoms to the upper extremity. 158 (71%) of these patients demonstrated DP at the initial evaluation. Within the MDT classification system these patients were classified as derangement. The average initial NDI score for this group of patients with DP was 33% (moderately disabled) and the average NDI score at discharge was 13% (minimally disabled) for this group of patients.
See the graph below for the results.
Give us a call if you are in the Oklahoma City metro area and suffering neck pain. We will methodically assess your necks movements for a preferred direction of movement to rapidly relieve neck pain. In the process we will teach you how to prevent future recurrences of these unwanted symptoms.
Don Stover PT
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Thanks for visiting my blog page. My name is Don Stover. I am a seasoned physical therapist in Oklahoma City OK. with over 20 years in the biz. I have a lot of knowledge and training in orthopedic PT and spine care. I will be sharing my thoughts on physical therapy for orthopedic problems such as spinal pain, extremity joint pain, sports injuries, health/fitness, and life in general. I hope you enjoy reading!
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