Physical Therapy Options for Treating the Cervical Spine
Steve Daisey MPT, CSCS

After a thorough history and examination, a treatment program is individualized based on your particular findings. Here are some of the common physical therapy treatment options for the cervical spine:

Joint Mobilization/Manipulation
After analyzing the movement of the entire cervical spine (skull down to about T3), we determine which segments move too little and which move too much. A gentle joint mobilization/manipulation can then be used to increase movement at those segments which move too little. This can be done passively (with you at rest) or during movement (mobilization with movement). Often, the upper cervical and lower cervical spine are restricted, placing increased stress on C3-C6 (where most degeneration occurs).

Strain/Counterstrain
This is an indirect technique used to decrease muscle guarding. A tender muscle point is found on the neck. The neck is then repositioned such that the point is no longer tender. The neuromuscular system then adjusts to this and shuts off the muscle guarding. Usually, movement becomes more free at that point. This is a nice technique to help reduce the acute effects of a strain.

Muscle Energy Technique
Used in lieu of a joint mobilization. In this case, your cervical muscles are put in the precise position to move a segment in order to free up movement.

Positional Distraction
Used to remove a meniscoid or impaction from a facet joint. Patients with this problem present with an inability to turn the head and neck to one side. Following positional distraction, movement is usually freed up, though it is sore for a few days as swelling is still present.

Soft Tissue Mobilization/Myofascial Release
This is a manual technique used to help reduce guarding or restricted muscles. Very often, the upper trapezius muscles are dense and restricted from over-use and benefit greatly from this technique.

Deep Cervical Muscle Stabilization
Strengthening exercises can be performed to re-learn how to stabilize the cervical spine during movement. Typically, the deep cervical flexors are found to be weak following injury.

Periscapular Strengthening
Strengthening of the muscles that attach the scapula (shoulder blade) to the cervical spine. Often, these muscles misfire or are altogether weakened after injury.

Muscle Stretching
Some of the muscles connecting the cervical spine to the shoulder blades tend to become tight. Simple muscle stretching techniques can help free up movement.

McConnell Taping
Specialized taping can be extremely beneficial for inhibiting muscles that are too active, or facilitating those which are under-active.

Modalities
Ultrasound and Electrical Stimulation are occasional adjuncts which may help reduce inflammation and muscle guarding.

Our Core Values Regarding Treatment

Physical Therapy should be delivered one-on-one by only a physical therapist
We do not believe in using "aides" or "techs" to perform any aspect of your treatment. Aides and techs do not have a physical therapy license and do not have the skills (or legal right) to treat your problem.

Evaluation of your problem needs to be comprehensive and detailed
Often, while your problem may be felt in one area, there are other areas that are affecting it. For instance, the hip and ankle can affect the lower back and the knee. Hidden problems in the neck will impact the shoulder. An evaluation is of your entire system, so that your treatment will give you the best chance of recovery, and enable you to maintain that level long after you’ve left our care.

No one single approach is the only answer
For example, some patients benefit from spinal manipulation, others from
strengthening and stabilization, many from a combination of the two. It is important to know as many treatment approaches as possible to find the correct, precise solution to your unique problem.

Treatment needs to be tailored to
your unique goals
For example, two patients may have the exact same shoulder diagnosis, but have lifestyles that place completely different demands on their shoulders. Rehabilitation must therefore be highly individualized to each patient to return them to their optimal level of function.

Everyone deserves excellence in healthcare
Physical therapy should be delivered in an atmosphere that is friendly, warm, fun, and above all, conducive to healing. Rehabilitation must be centered around YOUR needs, your timeline and your goals, and be provided by a highly trained physical therapist.

Orthopedic surgery can very often be prevented or delayed
Even with surgery, the body mechanics that led to problems in the spine, knees, and shoulders for example, still need to be corrected. By correcting them, surgery can often be avoided or delayed for years, giving you less pain and greater function.