Myelopathy
Mechanical neck pain
Cervical radiculopathy
Inflammatory joint disease
Fracture
Post trauma muscle strainTo help the student understand how the assessments work, these diagnostic guides outline the path that the assessments take that lead to relevant treatment...
1: Was there a trauma? No = go to 2
2: Has the patient got any significant limb weakness/ decreased sensation, loss of bowel/bladder, positive Babinski, Clonus or Hoffmans test? Yes = Myelopathy
Myelopathy treatment 
1: Was there a trauma? No = go to 2
2: Has the patient got any significant limb weakness/ decreased sensation, loss of bowel/bladder, positive Babinski, Clonus or Hoffmans test? No = go to 3
3: Does the pain go down the neck into their shoulder / arm / hand? No = go to 4
4: Is the pain central, localized to the neck? Yes = go to 5
5: Does the pain get worse on activity? Yes = go to 6
6: Is there a decrease in range of movement to the neck or pain on movement? Yes = go to 7
7: Is there muscle spasm or muscle tightness? Yes = Mechanical neck pain
Mechanical neck pain treatment
1: Was there a trauma? No = go to 2
2: Has the patient got any significant limb weakness/ decreased sensation, loss of bowel/bladder, positive Babinski, Clonus or Hoffmans test? No = go to 3
3: Does the pain go down the neck into their shoulder / arm / hand? Yes = go to 8
8: Does the pain / numbness correlate to a dermatome/ myotome? Yes = go to 9
9: Does the pain / symptoms get worse with the Spurlings test? Yes = go to 10
10: Is the pain sensitive to Upper Limb Tension Tests (ULTT) ? Yes = go to 11
11: Any positive testing for myotomes, dermatomes or reflexes? Yes = Cervical radiculopathy
Cervical radiculopathy treatment
1: Was there a trauma? No = go to 2
2: Has the patient got any significant limb weakness/ decreased sensation, loss of bowel/bladder, positive Babinski, Clonus or Hoffmans test? No = go to 3
3: Does the pain go down the neck into their shoulder / arm / hand? No = go to 4
4: Is the pain central, localized to the neck? Yes = go to 5
5: Does the pain get worse on activity? No = go to 8
8: Does the pain / numbness correlate to a dermatome/ myotome? No = go to 10
10: Is the pain sensitive to Upper Limb Tension Tests (ULTT)? No = go to 12
12: Was the pain a progressive onset over days or weeks? Yes = go to 13
13: Is the pain relieved with activity / movement? No = go to 14
14: Is the pain worse on waking in the morning or after rest? Yes = go to 15
15: Is there multi-joint stiffness, decreased range of movement or swelling? Yes = Inflammatory joint disease
Inflammatory joint disease treatment
1: Was there a trauma? Yes go to 16
16: Is there a sudden weakness or numbness to limbs and/or local ‘bony’ tenderness to the neck, or bladder or bowel dysfunction? Yes = Fracture
Fracture treatment
1: Was there a trauma? Yes = go to 16
16: Is there a sudden weakness or numbness to limbs and/or local ‘bony’ tenderness to the neck, or bladder or bowel dysfunction? No = go to 17
17: Is there localised muscular tenderness to the neck? Yes = Post trauma muscle strain
Post trauma muscle strain treatment
1: Has there been a fall/RTA/trauma? Yes = go 16
16: Is the neck segment painful to tap locally? Yes = Fracture
Fracture treatment
