CASE STUDY 30 YEAR OLD LOW NECK
PAIN FINAL PAPER 2026 QUESTIONS
WITH ANSWERS GRADED A+
⩥ Limited range of motion with pain at end range with AROM/PROM
restricted CS or TS segmental/intersegmental mobility
Cervical rotation lateral flexion - first rib, mob, and CTJ mobility
Primarily restriction at the joint or capsule, but patients with lack of
flexibility in the cervical thoracic musculature also fits into the category
patient with OA changes fit into the category
Referred pain with segment provocation
Decreased CS or TS strength and motor control. Answer: Neck pain with
mobility deficits, physical impairment, and examination
⩥ B = thoracic spine manip
B = neck ROM and scapulothoracic UE strengthening ex
C = cervical mobilization/manip
,C = general fitness
C = supervised exercise for CS / Ts. Answer: Neck pain with mobility
deficits - Acute intervention
⩥ B = neck and shoulder endurance exercise
C = thoracic spine and cervical spine mobs/manip. Answer: Neck pain
with mobility deficits - Subacute intervention
⩥ B = mixed exercise
- (B) TS/CS mobs/manip
- (B) neck and shoulder ex
- (B) needling, laser, traction
C = neck, shoulder, trunk endurance ex and patient education for active
lifestyle, cognitive, affective factors, TENS. Answer: Neck pain with
mobility deficits - Chronic intervention
⩥ - Trauma or whiplash
- referred pain - shoulder girdle or referred UE pain
- concussive signs, dizzy, nausea, headache, concentration issues, or
sensitive to smells, temp, light. Answer: Neck pain with movement
coordination impairments SYMPTOMS
⩥ - + cranial cervical flexion test - decrease of 20% over the 10 sec hold
, - In CCFT - > 26 mmhg for no neck pain patients, <26 mmhg for neck
pain patients
- + deep neck flexor endurance - < 24.5 sec in patients with neck pain
- + pain pressure threshold = 4-5 N/s
- pain at mid range, worse with end range
- trigger points
- coordination, strength, flexibility, deficits of upper quarter
- ergonomic inefficiencies
- decreased proprioception or balance
- pain with cervical segment palpation. Answer: Neck pain with
movement coordination impairments physical impairments and
examination
⩥ - B education including = return to normal pre accident activities
ASAP, postural and mobility exercise, minimize collar use
- B reassurance - recovery in 2-3 months
- B manual mobs + exercise (Strengthening, endurance, flexibility,
posture, aerobic, etc)
For patients at low risk of progress towards chronicity
- C = single session of ed and ex (comprehensive HEP)
- C = tens
- F = monitor recovery status in attempt to identify those experiencing
delayed recovery who may need more intensive rehab and an early pain
PAIN FINAL PAPER 2026 QUESTIONS
WITH ANSWERS GRADED A+
⩥ Limited range of motion with pain at end range with AROM/PROM
restricted CS or TS segmental/intersegmental mobility
Cervical rotation lateral flexion - first rib, mob, and CTJ mobility
Primarily restriction at the joint or capsule, but patients with lack of
flexibility in the cervical thoracic musculature also fits into the category
patient with OA changes fit into the category
Referred pain with segment provocation
Decreased CS or TS strength and motor control. Answer: Neck pain with
mobility deficits, physical impairment, and examination
⩥ B = thoracic spine manip
B = neck ROM and scapulothoracic UE strengthening ex
C = cervical mobilization/manip
,C = general fitness
C = supervised exercise for CS / Ts. Answer: Neck pain with mobility
deficits - Acute intervention
⩥ B = neck and shoulder endurance exercise
C = thoracic spine and cervical spine mobs/manip. Answer: Neck pain
with mobility deficits - Subacute intervention
⩥ B = mixed exercise
- (B) TS/CS mobs/manip
- (B) neck and shoulder ex
- (B) needling, laser, traction
C = neck, shoulder, trunk endurance ex and patient education for active
lifestyle, cognitive, affective factors, TENS. Answer: Neck pain with
mobility deficits - Chronic intervention
⩥ - Trauma or whiplash
- referred pain - shoulder girdle or referred UE pain
- concussive signs, dizzy, nausea, headache, concentration issues, or
sensitive to smells, temp, light. Answer: Neck pain with movement
coordination impairments SYMPTOMS
⩥ - + cranial cervical flexion test - decrease of 20% over the 10 sec hold
, - In CCFT - > 26 mmhg for no neck pain patients, <26 mmhg for neck
pain patients
- + deep neck flexor endurance - < 24.5 sec in patients with neck pain
- + pain pressure threshold = 4-5 N/s
- pain at mid range, worse with end range
- trigger points
- coordination, strength, flexibility, deficits of upper quarter
- ergonomic inefficiencies
- decreased proprioception or balance
- pain with cervical segment palpation. Answer: Neck pain with
movement coordination impairments physical impairments and
examination
⩥ - B education including = return to normal pre accident activities
ASAP, postural and mobility exercise, minimize collar use
- B reassurance - recovery in 2-3 months
- B manual mobs + exercise (Strengthening, endurance, flexibility,
posture, aerobic, etc)
For patients at low risk of progress towards chronicity
- C = single session of ed and ex (comprehensive HEP)
- C = tens
- F = monitor recovery status in attempt to identify those experiencing
delayed recovery who may need more intensive rehab and an early pain
