Evidence-Based Approach to the Physical Therapy Diagnosis and Management of Neck and Upper Extremity Pain using Cervical and Thoracic Spine Thrust: A Case Report

Paul E. Glynn, DPT, OCS and Joshua A. Cleland, DPT, PhD, OCS

The purpose of this case report is to describe an evidence-based approach to the physical therapy diagnosis and management a patient with cervical radiculopathy. Management was based on a treatment-based classification approach and focused on restoring mobility by way of thrust manipulations directed at the thoracic and cervical spine. At the completion ofthe physical therapy plan of care all outcome measures had improved and were maintained at six weeks from discharge. The authors conclude that while a cause-and-effect relationship cannot be inferred from a case report, it is plausible that an orthopaedic manual physicaltherapy approach in the management of patients with both neck and upper extremity painmay result in decreased pain and improved function. Further clinical trials are needed totest this hypothesis.

The Journal of Manual & Manipulative Therapy Vol. 14 No. 3 (2006)

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