Article

The Royal Dutch Society for Physical Therapy (KNGF) issued a clinical practice
guideline for physical therapists that addresses the assessment and treatment of
patients with nonspecific neck pain, including cervical radiculopathy, in Dutch
primary care. Recommendations were based on a review of published systematic
reviews.During the intake, the patient is screened for serious pathologies and
corresponding patterns.
Patients with cervical radiculopathy can be included or
excluded through corresponding signs and symptoms and possibly diagnostic tests
(Spurling test, traction/distraction test, and Upper Limb Tension Test). History
taking is done to gather information about patients' limitations, course of pain,
and prognostic factors (eg, coping style) and answers to health-related
questions.In case of a normal recovery (treatment profile A), management should
be hands-off, and patients should receive advice from the physical therapist and
possibly some simple exercises to supplement "acting as usual."In case of a
delayed/deviant recovery (treatment profile B), the physical therapist is advised
to use, in addition to the recommendations for treatment profile A, forms of
mobilization and/or manipulation in combination with exercise therapy. Other
interventions may also be considered. The physical therapist is advised not to
use dry needling, low-level laser, electrotherapy, ultrasound, traction, and/ or a
cervical collar.In case of a delayed/deviant recovery with clear and/or dominant
psychosocial prognostic factors (treatment profile C), these factors should first
be addressed by the physical therapist, when possible, or the patient should be
referred to a specialist, when necessary.In case of neck pain grade III
(treatment profile D), the therapy resembles that for profile B, but the use of a
cervical collar for pain reduction may be considered. The advice is to use it
sparingly: only for a short period per day and only for a few weeks.

Langue : ANGLAIS