Lesson 1Medication and Previous 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 Zambia.
Current painkillers and dosage detailsPast physiotherapy and hands-on 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 Zambian contexts.
Patient story 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 hands-on techniques, exercise dosing, and referral urgency for safe practice in Zambia.
Blood thinners and bleeding riskInflammatory and autoimmune disordersSuspected neck instability signsWeak bones and fracture risk factorsHeart and blood vessel riskRed-flag symptoms requiring referralLesson 4Nerve Symptom Exploration: Shooting Pain, Tingling, Weakness, Spread PatternThis section investigates nerve symptoms such as shooting pain, tingling, weakness, and sensory changes, mapping spread and irritability to identify nerve root involvement and potential serious pathology in Zambian patients.
Shooting pain pattern and severityTingling, numbness, and pins-and-needlesSubjective weakness and clumsinessSkin area and muscle distributionBowel, bladder, and walking changesSymptom irritability and delayLesson 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 Zambia.
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, Number ScalesThis section details pain intensity, quality, and spread using validated scales and diagrams, capturing temporal patterns, irritability, and multi-site symptoms to monitor change and support clinical reasoning in local settings.
Number and visual analog scalesPain quality descriptors and irritabilityTemporal pattern and flare-up behaviourBody charts and pain spread mapsNeck disability and function measuresInterpreting minimal important changeLesson 7Red Flags and Medical History: Signs of Infection, Body-Wide Disease, Cancer, Recent InjuryThis section screens for red flags and broader medical history, including infection, cancer, body-wide disease, and recent injury, integrating risk factors and symptom clusters to determine urgency of medical referral in Zambia.
Fever, weight loss, and night sweatsHistory of cancer or serious illnessRecent injury or high-risk accidentsNerve or spinal cord signsHeart and lung historyMedication, surgery, and allergy historyLesson 8Key Pain History Elements: Onset, Duration, Progression, Pattern, Worsening and Easing FactorsThis section structures key pain history questions, covering onset, duration, progression, daily pattern, and worsening and easing factors, to differentiate mechanical from non-mechanical pain and guide hypothesis generation for Zambian clinicians.
Initial onset and triggering eventsDuration, frequency, and episode patternProgression, stability, or worseningDaily variation and night painWorsening 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 Zambia.
Desk, chair, and monitor positioningKeyboard, mouse, and typing habitsLaptop, tablet, and phone use patternsBreak frequency and short-break 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 Zambia.
Sleep onset, maintenance, and waking painWork stress, life events, and coping styleMood, anxiety, and pain catastrophisingPhysical activity level and sitting timeCaffeine, alcohol, and tobacco patternsScreen time, device use, and wind-down
