Lesson 1Medication and prior treatment history: analgesics, physiotherapy, imaging, response to treatmentsThis section reviews current and past medications, physiotherapy, injections, and imaging, focusing on treatment responses, side effects, adherence, and red-flag clues that influence clinical reasoning and guide safe, effective management choices.
Current analgesics and dosage detailsPast physiotherapy and manual therapyPrevious injections or surgical proceduresImaging findings and clinical relevanceTreatment response and side effectsAdherence, beliefs, and self-managementLesson 2Patient goals and expectations: short- and long-term functional goals and preferred outcomesThis section clarifies the patient’s short- and long-term goals, preferred outcomes, and expectations of physiotherapy, aligning assessment and treatment plans with meaningful functional targets and shared decision-making principles.
Patient narrative of main concernsShort-term symptom relief prioritiesLong-term functional and role goalsReturn-to-work and sport expectationsAcceptable pain levels and timelinesShared decision-making and preferencesLesson 3Precautions and contraindications: anticoagulants, inflammatory conditions, cervical instabilityThis section identifies medical precautions and contraindications, including anticoagulant use, inflammatory disease, cervical instability, and osteoporosis, to adapt manual techniques, exercise dosing, and referral urgency for safe practice.
Anticoagulants and bleeding riskInflammatory and autoimmune disordersSuspected cervical instability signsOsteoporosis and fracture risk factorsCardiovascular and vertebrobasilar riskRed-flag symptoms requiring referralLesson 4Neurological symptom exploration: radicular symptoms, paresthesia, weakness, distributionThis section investigates neurological symptoms such as radicular pain, paresthesia, weakness, and sensory changes, mapping distribution and irritability to identify nerve root involvement and potential serious pathology.
Radicular pain pattern and severityParesthesia, numbness, and tinglingSubjective weakness and clumsinessDermatomal and myotomal distributionBowel, bladder, and gait changesSymptom irritability and latencyLesson 5Functional impact questions: activities of daily living, work tasks, exercise toleranceThis section examines how cervicothoracic pain affects daily self-care, work tasks, driving, and exercise, quantifying limitations, compensations, and participation restrictions to prioritize functional goals and outcome measures.
Self-care and personal hygiene tasksHousehold and caregiving activitiesWorkstation and job-specific demandsDriving, commuting, and travel toleranceExercise, sport, and leisure restrictionUse of aids, supports, and adaptationsLesson 6Pain characteristics and scales: intensity, quality, timing, pain diagrams, numerical scalesThis section details pain intensity, quality, and distribution using validated scales and diagrams, capturing temporal patterns, irritability, and multi-site symptoms to monitor change and support clinical reasoning.
Numeric and visual analog scalesPain quality descriptors and irritabilityTemporal pattern and flare-up behaviorBody charts and pain distribution mapsNeck disability and function measuresInterpreting minimal important changeLesson 7Red flags and medical history: signs of infection, systemic disease, cancer, recent traumaThis section screens for red flags and broader medical history, including infection, cancer, systemic disease, and recent trauma, integrating risk factors and symptom clusters to determine urgency of medical referral.
Fever, weight loss, and night sweatsHistory of cancer or serious illnessRecent trauma or high-risk accidentsNeurological or myelopathic signsCardiovascular and respiratory historyMedication, surgery, and allergy historyLesson 8Key pain history elements: onset, duration, progression, pattern, aggravating and easing factorsThis section structures key pain history questions, covering onset, duration, progression, diurnal pattern, and aggravating and easing factors, to differentiate mechanical from non-mechanical pain and guide hypothesis generation.
Initial onset and precipitating eventsDuration, frequency, and episode patternProgression, stability, or worseningDiurnal variation and night painAggravating movements and posturesEasing factors, rest, and medicationsLesson 9Workstation and activity-specific inquiry: computer use duration, posture, breaks, typing habitsThis section analyzes workstation setup and task-specific activities, including computer use, posture, breaks, and manual tasks, to identify modifiable ergonomic and behavioral contributors to cervicothoracic pain.
Desk, chair, and monitor positioningKeyboard, mouse, and typing habitsLaptop, tablet, and phone use patternsBreak frequency and microbreak habitsManual handling and lifting demandsDriving posture and in-vehicle setupLesson 10Sleep, psychosocial and lifestyle screening: sleep quality, stress, mood, activity levelsThis section explores sleep quality, stress, mood, and lifestyle habits, linking them to pain intensity, recovery, and flare-ups, and identifying modifiable psychosocial and behavioral factors that may require education, pacing, or referral.
Sleep onset, maintenance, and waking painWork stress, life events, and coping styleMood, anxiety, and pain catastrophizingPhysical activity level and sedentary timeCaffeine, alcohol, and nicotine patternsScreen time, device use, and wind-down
