Regional Localization

Regional Localization Purpose of Skill: Regional localization is a technique used to localize neck/back pain to a particular region of the spine in patients who present with painful/limited cervicothoracic rotation. Neck/back pain presents differently in each patient, and it can sometimes be difficult to pinpoint the exact location of pain. Your first goal is to differentiate between cervical and thoracic pain. Step 1: 0:27 Start with the patient sitting upright at the corner of the table with their feet planted on the floor. Have the patient describe their current pain location (left vs right side) and pain intensity (using the 0-10 scale) to establish a baseline. Step 2: 0:45 Have the patient rotate at the thoracic spine AWAY FROM the painful side while keeping the cervical spine in neutral. IE. If the patient has right sided neck/back pain, rotate to the left. Step 3: 1:06 Standing behind the patient, stabilize their thoracic spine in this position by holding their shoulders. Note the patient's pain location and intensity in this position as well. Step 4: 1:20 Have the patient rotate their head TOWARD the painful side. Again, ask the patient to rate their pain. If pain is the same or worse with cervical rotation, this is indicative of a cervical source of pain. Step 5: 1:45 In cases of cervical pain, you can further differentiate between upper and lower cervical pain. Have the patient actively flex their cervical spine, then rotate their head TOWARD the painful side. If pain is worse in this position, this indicates UPPER cervical spine pain. This test is not diagnostic, but can help to guide examination and intervention. Evidence Austin, 2011. 21.1.4 pp. 13