Common Vertebral Joint Problems

1. Applied anatomy - regional

Upper CervicalCervicalTemporomandibular jointCervicotheracicThoracic spine and ribsLumbarPelvic joitnsSurface anatomy

2. Applied anatomy - general

Articular cartilageSynovial joint lubricationFibrous connective tissuesMuscleVertebral movementThe lumbar mechanism Intervertebral foramenBiomechanics of spinal cord and meningesVenous drainageAutonomic nervous systemPatterns of somatic nerve root supply

3. Aetiology in general terms

4. Incidence

GeneralSegmental

5. Pathological changes - general

Synovial joitnsVertebral body jointsNerve root involvement Soft tissuesNeoplasms

6. Pathological changes - combined regional

Upper cervicalCervicalCervicothoracicThoracicLumbarSphincter disturbancePelvisSerious pathology simulating musculoskeletal pain

7. Clinical features

Neurological changesPain and tendernessAutonomic nervous system in vertebral pain syndromesReferred painAbnormalities of feeling Changes in muscle and soft tissueDeformityFunctional disablementPsychological aspects

8. Common patterns of clinical presentation

Arthrosis and spondylosisUpper cervicalTemporomandibular jointCervicalCervicothoracicClavicular jointsThoracic and rib jointsLumbar spine and pelvisPelvic arthropathyDrug-induced joint and muscle painsNeoplasms

9. Examination

IntroductionHistoryObservationPhysical testsSpecial testsPalpationRegional examination procedures Temporomandibular jointNeck and forequarterShoulderShoulder girdleThoracic regionBack and hindquarterSacroiliac jointHip jointPassive physiological-movement testsStructural and neural interdependence

10. Investigation procedures

11. Principles of treatment

AimsManipulation in general terms Passive movement - definitionsTechniques1. Massage2. Maintenance movements3. Mobilisation - regional, localised, limb girdles4. Manipulation - regional, localised5. Correction of listing6. Stretching7. Traction - manual and mechanical8. Recording passive movement treatment: clinical methodManually assisted or manually resisted movements1. Self-correction of listing2.Post-isometric relaxation3. Proprioceptive neuromuscular facilitationActive Movements1.Exercises for strength and mobility2. Autrotraction3. Soft-tissue stretching

12. Indications

13. Contraindications

14. Supports and appliances and adjunct physical treatments

15. Medication and alternative methods of pain relief

16. Prophylaxis

17. Invasive procedures

MinorMajor

Index