What to look out for, what to do, and when: 3 key messages for safely treating neck pain, headache and/or orofacial symptoms in musculoskeletal rehabilitation settings

Nathan Hutting, Firas Mourad, Rik Kranenburg, Wilfred Wilbrink, Roger Kerry, Alan Taylor

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

SYNOPSIS: Neck pain, headache, and/or orofacial symptoms are potentially the first (non-ischaemic) symptoms of an underlying vascular pathology or blood flow limitation. If an underlying vascular pathology or blood flow limitation is not recognized by the musculoskeletal rehabilitation clinician, it can subsequently be aggravated by treatment, raising the risk of serious adverse events. We argue that clinicians can make an important, and potentially lifesaving difference, by providing specific information and advice. This is especially the case in patients with an intermediate level of concern for example in patients who only show a few concerning features regarding a possible underlying serious condition, and for whom an initial vasculogenic hypothesis was rejected during the clinical reasoning process. We present background information to help the reader understand the context of the problem, and suggestions for how clinicians can provide appropriate information and advice to patients who present with neck pain, headache, and/or orofacial symptoms.

Original languageEnglish
Pages (from-to)1-14
Number of pages14
JournalJournal of Orthopaedic and Sports Physical Therapy
DOIs
Publication statusE-pub ahead of print - 28 Oct 2022

Keywords

  • physical therapy
  • musculoskeletal care
  • communication
  • safety netting
  • vascular pathologies

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