Fall 2004

H e a l t h   P r o m o t i o n
“Oh, my aching neck! Doc, what can you do for me?”


We all know these kinds of complaints — particularly those that return again and again — can be challenging.

     “Oh my aching neck (back, shoulder or knee)!” Four words frequently heard in doctor’s offices everywhere. We all know these kinds of complaints — particularly those that return again and again — can be challenging.
     A highly skilled group of physiotherapists are providing an effective treatment option for complicated complaints like those plaguing the ‘aching’ patient in your waiting room. Through their unique approach, these physiotherapists are seeing evidence-based proof that, for some conditions such as headaches, neck pain, frozen shoulder, nerve root compression and decreased joint mobility, their mode of therapy is extremely effective.
     Fellows of the Canadian Academy of Manipulative Therapy (FCAMT) are a group of skilled physiotherapists with extensive post-graduate education, who have passed an internationally recognized accreditation process. As a result, they have a comprehensive understanding of advanced manual therapy — a key component of the multi-modal approach.
     The multi-modal approach has been proven effective in studies including The Cochrane Collaboration’s April 2004 updated systematic review Mobilization and Manipulation for Mechanical Neck Disorders. These 33 studies concluded that individuals with neck pain and neck pain combined with headache had better outcomes (pain and function) when multi-modal therapy was applied. Other studies also show similar results for mechanical pain disorders.
     Focused on long-term solutions, the multi-modal approach practiced by members includes several key components.

Manual Therapy
     A typical course of multi-modal treatment includes advanced manual therapy; hands on manual and manipulative techniques aimed at improving movement in stiff joints and tight muscles.

     Exercise of the affected areas is used to help activate muscles and control movement. It is a major component of relief and recovery in the multi-modal approach, and physiotherapists work closely with patients to develop exercises tailored to help improve function.

Analysis and Patient Education
     A detailed analysis of the patient’s day-to-day activities at work, rest and play is conducted to pinpoint the activities causing or contributing to the problem.
     Once the root of the disorder is identified, patients are educated on the causes of their condition, re-educated on proper movement, and taught self-management.

Other Modalities
     Modalities such as ultrasound, laser, electrical current or acupuncture may be used as adjunctive treatment. These techniques promote pain control, reduce inflammation and encourage better blood supply to injured areas, improving the environment for healing.

     If you have patients with challenging orthopaedic conditions, a multi-modal treatment approach from a physiotherapist trained in advanced manual therapy could help. Please visit manipulativetherapy.org to “Find a Therapist” near you.


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Nexus is published quarterly for Newfoundland and Labrador's physicians. It is a forum for the exchange of views, ideas and information for members.