Articular dysfunction patterns in mechanical neck pain
This study aims to provide clinicians with an algorithm to guide the identification of patients with neck pain who are more likely to respond positively to mobilization and /or manipulation techniques of the cervical spine. The model proposed is based on empirical evidence and it is applicable for patients with mechanical nociception arising from the articular structures of the neck.
Based on key features collected during clinical examination, such patients can be categorized into 2 specific articular dysfunction patterns; the convergence pattern which is characterized by pain provocation and motion restriction in a combination of extension, ipsilateral side bending and rotation and the divergence pattern during which motion is restricted and symptoms are provoked with flexion, contralateral side bending and rotation.
The treatment of the different patterns requires specific mobilization and manipulation techniques with distinct goals. Combination of the patterns might occur and thus online adaptation of the framework to the needs of the patient under realistic circumstances is the key to an effective treatment.