Pain Loss of function Inability to do A.D.L activities.

1. Problem List • Pain • Loss of function • Inability to do A.D.Lactivities.

2. Treatment Treatment steps need to cover the following: 1 2 Short term goals Long term goals

3. Short term goals 1-Reliefof pain 2-Improve function 3-Improve ADL activities

4. Relief of pain • Initially, relative rest should be recommended • Soft neck collar • Positioning : Molded cervical pillows. Rest

5. Heat and cold • Cold packs may be used to reduce pain for fifteen minutes. • Heat packs for twenty minutes. • Contrast bath.

6. Pulsed electromagnetic field stimulation • Pulsed Electromagnetic Field improves pain and neck stifness. • PEMF is applied for 30 min on 6 consecutive days.

7. TENS • Transcutaneous Electrical Nerve Stimulation for thirty minutes. (blocking of pain impulses) • Neck pain (Trans regional) ,Referred pain (nerve trunk techniques).

8. Deep transverse friction Massage • Manual massage of posterior cervical muscles from C7 to occiput • Cervical traction technique.

9. To improve function • Isometric Exercises to maintain strength • Neck And upper Back Stretching Exercises. • Light aerobic Exercises Restoratio of Range,Flexibility,And Strengh Of Neck Muscles

10. Proper Stretching Technique • stretch the muscles on both sides of your body evenly . • Avoid over stretching. • All Stretches should be smooth and slow. • Deep, easy and even breathing is the key to relaxation. • It is important to stop stretching when you feel pain or discomfort.

11. Neck Stretching Exercises • Neck assisted flexion • Apply slight pressure to the top of the head with either hand to increase the stretch. • Neck assisted extension • Apply slight pressure to the top of the head with either hand to increase the stretch.

12. Neck Stretching Exercises • Neck assisted lateral flexion. • Apply slight pressure to the side of the head with the same side hand to increase the stretch. • Neck assisted rotation • Apply slight pressure to the side of the head to increase the stretch

13. Neck Isometric Exercises From a neutral position, gently contract your neck muscles against the resistance provided by your hands in a forward position.  

14. Neck Isometric Exercises From a neutral position, gently contract your neck muscles against the resistance provided by your hands in a backward and side bending position

15. Aerobic Exercises Place both the hands on the shoulders. Bring both elbows together in front *  Slowly push the elbows and the shoulders backwards *  Hold for 10 - 15 counts *  Breathe normally.

16. Aerobic Exercises •   Place both the hands on the shoulders. Bring both the elbows together in front. •   Slowly raise the elbows and shoulders upwards, trying to touch your ears. • Hold for fifteen minutes. • Breath normally.

17. Aerobic Exercises •   Slowly rotate the elbows and the shoulders clockwise raising the elbows up over the head and down again • Place both the hands on the shoulders. Bring both the elbows together in front.

18. Aerobic Exercises • Repeat the same movement anti-clockwise • Repeat five times in each direction.

19. Gymnastic ball exercises

20. Gymnastic ball exercises

21. Gymnastic ball exercises

22. Long term goals Coming back to job/sport activities Done by Occupational therapist Occupational Therapy:The goal of Occupational Therapy is to enable an individual to carry out their activities of daily living, which include those performed at work, home, school and the community, as independently as possible.

23. Advices • Good posture should be maintained. • Avoid slouching rounded shoulders • Avoid the neck poke position • Avoid working with the head down for long periods • Ensure that your work ergonomics are correct • Pull your shoulder blades down and in to improve your shoulder position

24. Postural Awareness

25. Postural Awareness Bad body mechanics

26. Thank you