Other cervical spine treatments
Notes
Cervical spine
Other cervical spine treatments
Below are several techniques that are less commonly taught at osteopathic schools and / or rarely tested on the COMLEX® exams. These lists are not fully inclusive but are meant to highlight some of the most common or useful applications of each technique. The exception to this is suboccipital release, which is very frequently used in practice and tested on examinations.
ARTICULATORY
Diagnosis: Cervical rotation somatic dysfunction
- With the patient lying supine, rotate the head and neck to the side of restriction and support the patient’s head so that your forearm is across the cheekbone and your fingers are at the mandible
- Cradle the occiput with your other hand
- Use the edge of the proximal third finger to spring into the barrier, hold briefly, and return to neutral
- Repeat motion in a slow, rhythmic fashion
Diagnosis: Cervical sidebending somatic dysfunction
- With the patient lying supine, place the palmar aspect of third finger against a specific joint level at the lateral articular pillar; it will act as a fulcrum on the side opposite of the restriction
- Grasp the posterior aspect of the head with the opposite hand
- Use lateral translation to induce side bending against the barrier
- Return to neutral and repeat in a slow, rhythmic fashion
BALANCED LIGAMENTOUS TENSION
OA Joint
Example diagnosis: OA E SLRR
- With the patient lying supine, stand / sit at the head of the table and palpate the patient’s C1 transverse processes
- Lift the C1 transverse processes to produce a relative position of ease at the OA joint (extended, side bent left, rotated right in this case)
- Gently side bend left and rotate right until a point of balanced tension is palpated
- Hold this position until a release is palpated
AA Joint
Example diagnosis: AA RL
- With the patient lying supine, stand / sit at the head of the table and palpate the patient’s C2 articular processes
- Lift the C2 articular processes to produce a relative position of ease at C1 (rotated left in this case)
- Gently rotate C1 to the right until a point of balanced tension is palpated
- Hold this position until a release is palpated
C2–C7
Example diagnosis: C4 F SRRR
- With the patient lying supine, stand / sit at the head of the table and palpate the patient’s C5 articular processes
- Lift the C5 articular processes to produce a relative position of ease at C4 (side bent right, rotated right in this case)
- Gently rotate C4 to the right, and add axial compression from the top of the head toward C4, until a point of balanced tension is palpated
- Hold this position until a release is palpated
SOFT TISSUE
Supine traction
- With the patient lying supine, sit at the head of the table
- Cradle the occiput with one hand and place the other hand across the patient’s forehead or under the chin
- Exert cephalad traction with both hands in a neutral and slightly flexed position to avoid extension
- Apply and release the tractional force slowly; increase the amplitude per patient tolerance
Bilateral forearm fulcrum, forward bending method
- With the patient lying supine, sit at the head of the table
- Cross your arms under the patient’s head and place your palms on the anterior shoulders
- Gently flex the patient’s neck with your forearms, producing a longitudinal stretch of the cervical paravertebral musculature
Suboccipital release
- With the patient lying supine, sit at the head of the table
- Place finger pads in the patient’s suboccipital region
- Gently apply anterior and superior pressure into the tissues until a release is palpated
Lateral traction with shoulder block, supine
- With the patient lying supine, sit at the head of the table
- Place one palm on top of the patient’s shoulder on the side to be treated
- Place your other hand across the patient’s head / face to contact the paravertebral musculature contralateral to that hand
- Gently move the head until the restrictive barrier is met and hold the position for 3–5 seconds, then slowly return the head to neutral
For Institutions
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