15 Dec 2017

Winter 2017 - Neurology

Nerve related conditions was the second most common diagnosis encountered by our members, based on the results of our 2016 practice profile survey. Our winter edition of In Touch, therefore looks at aspects of nerve related MSK pain, whiplash affected disorders and radiculopathy with the aim of informing clinical reasoning and practice and supporting our members towards becoming Quality Assured Practitioners.

Predicting prognosis in whiplash

In the last decade there has been considerable progress in the field of whiplash injury with respect to recovery and outcome. The aim of this review is to present the evidence base with respect to the assessment of whiplash injury. The emphasis will be placed upon identifying those at risk of poor recovery by reviewing the subjective assessment of whiplash injury (crash related factors, pain, disability, dizziness and psychological disturbance) and those “objective” tests (probably more accurately described as “psychophysical” tests) that can be performed easily in the clinical setting

Chris Worsfold

 Predicting prognosis in whiplash.pdf


Management of people with nerve related musculoskeletal pain

Nerve related musculoskeletal (MSK) pain is a common presentation for people presenting themselves to physiotherapists. The specific pathobiological mechanisms vary considerably between patients, and treatment options therefore must be made on an individual basis and based on a thorough assessment. This article gives an overview of some of the treatment options for people with nerve related MSK pain. It discusses the possible effects of such treatments, supported by some exciting animal and human studies and the efficacy of these treatments referring to the latest available evidence.

Collette Ridehalgh

An evidence based approach to managing lumbar radicular pain and radiculopathy - a physiotherapist's perspective

Lumbar radicular pain and radiculopathy is a common condition that is frequently managed by physiotherapists. Best practice requires an evidence-based approach and clinical practice guidelines (CPG) provide a framework for treatment. The National Institute for Health and Care Excellence (NICE) has published low back pain guidelines that for the first time included information on sciatica (NICE 2016). This article summarises the clinical decision-making for patients with lumbar radicular pain and radiculopathy, discussing the subjective and objective examination, differential diagnosis and screening for red flags.

Louise Hailey & Annina Shmid

A best practice guide to management of recent onset cervical radiculopathy in people presenting to primary care

During the World Health Organisation’s (WHO) bone and joint decade 2000-10, the taskforce on neck pain highlighted the existence of a gap in the research for the optimal management of cervical radiculopathy (CR) despite the high levels of pain and disability associated with this condition. With a prevalence less than half that seen for lumbar radiculopathy, the research gap for CR is most evident for the first 12 weeks of the condition, making evidence-based clinical decision-making a challenge for primary carers. Informed by recent primary and secondary research in CR and neuropathic pain, a best practice management guide is outlined for the physiotherapist in private practice and could assist them in the QAP process.

Louise Keating

The Private Detective: a closer look at the pelvic floor in athletes with pelvic pain (conference 2018 taster article)

The potential for undiagnosed musculoskeletal injuries in the difficult-to-access regions of the pelvis and pelvic floor to develop into chronic disability requires us, as physiotherapists, to become detectives in our own clinics in order to establish where a patient’s pelvic pain is originating and whether it is linked to pelvic floor muscle function. The content of this article forms part of a more extensive look into the research and clinical reasoning available in diagnosing and treating the many causes of musculoskeletal pelvic pain.

Ruth Jones