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Abstract
Objectives To measure changes in cervical spine joint ranges of movement before and after treatment, to allow classification of cases and to provide evidence of the effects of manual and other therapy
Methods Lateral radiographs of the cervical spine were obtained of cases with acute neck pain, in maximum flexion and extension, before and after treatment, and in follow-up. Ranges of movement were measured for the atlanto-axial joint, and the lower cervical joints, and compared with normal ranges for these joints.
Results Twenty-one cases of acute neck pain were classified into three groups radiographically: (i) locking of the suboccipital joint; (ii) locking of the lower cervical joints; and (iii) a combination of subluxation of the suboccipital joint and locking of the lower cervical joints. Objective evidence of changes in mobility of these joints was obtained.
Conclusions Improvement in range of movement corresponded with clinical improvement or lack of improvement. The method of therapy is described: it consists of positional distraction by placing small pillows under the spinal and pelvic bones in sitting, side-lying and supine positions, osteokinematic passive gliding and arthrokinematic passive gliding, and continues until lower cervical and atlanto-axial joint motion improve radiographically. The clinical impression that sacroiliac joint dysfunction is associated with neck dysfunction is discussed including the importance of correcting any associated areas of joint dysfunction.