Lesson 1Medication and Prior Treatment History: Painkillers, Physiotherapy, Scans, 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 for patients in Ghana.
Current painkillers and dosage detailsPast physiotherapy and manual therapyPrevious injections or surgical proceduresScan 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 suitable for Ghanaian contexts.
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: Blood Thinners, Inflammatory Conditions, Neck InstabilityThis section identifies medical precautions and contraindications, including blood thinner use, inflammatory disease, neck instability, and weak bones, to adapt manual techniques, exercise dosing, and referral urgency for safe practice in local clinics.
Blood thinners and bleeding riskInflammatory and autoimmune disordersSuspected neck instability signsWeak bones and fracture risk factorsHeart and blood vessel riskRed-flag symptoms requiring referralLesson 4Neurological Symptom Exploration: Nerve Root Pain, Tingling, Weakness, DistributionThis section investigates neurological symptoms such as nerve root pain, tingling, weakness, and sensory changes, mapping distribution and irritability to identify nerve root involvement and potential serious pathology in everyday assessments.
Nerve root pain pattern and severityTingling, numbness, and pins and needlesSubjective weakness and clumsinessSkin area and muscle distributionBowel, bladder, and walking changesSymptom irritability and latencyLesson 5Functional Impact Questions: Daily Activities, Work Tasks, Exercise ToleranceThis section examines how neck and upper back pain affects daily self-care, work tasks, driving, and exercise, quantifying limitations, compensations, and participation restrictions to prioritise functional goals and outcome measures in Ghanaian settings.
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 in patient care.
Numeric and visual analog scalesPain quality descriptors and irritabilityTemporal pattern and flare-up behaviourBody 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 in local health systems.
Fever, weight loss, and night sweatsHistory of cancer or serious illnessRecent trauma or high-risk accidentsNeurological or spinal cord signsHeart and lung 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, daily pattern, and aggravating and easing factors, to differentiate mechanical from non-mechanical pain and guide hypothesis generation for better outcomes.
Initial onset and precipitating eventsDuration, frequency, and episode patternProgression, stability, or worseningDaily variation and night painAggravating movements and posturesEasing factors, rest, and medicationsLesson 9Workstation and Activity-Specific Inquiry: Computer Use Duration, Posture, Breaks, Typing HabitsThis section analyses workstation setup and task-specific activities, including computer use, posture, breaks, and manual tasks, to identify modifiable ergonomic and behavioural contributors to neck and upper back pain in work environments.
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 behavioural factors that may require education, pacing, or referral in Ghana.
Sleep onset, maintenance, and waking painWork stress, life events, and coping styleMood, anxiety, and pain catastrophisingPhysical activity level and sedentary timeCaffeine, alcohol, and nicotine patternsScreen time, device use, and wind-down
