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A 43-year-old female was referred to outpatient physical therapy for chronic neck pain by her family physician. The patient has worked as an administrative assistant for the past 20 years. Her initial onset of neck pain was 2 years ago with a significant increase in pain in the past 6 months. On the visual analog scale, she reports a pain score of 2/10 at the beginning of the day, which worsens to 10/10 by the end of the day. She describes her symptoms as "tightness" and "aching" extending from the superior scapula and shoulder up toward her neck and occipital area. She reports recently having headaches and an "aching" pain radiating into her dominant right arm by the end of the day. Her day consists of sitting at a computer 75% of the time and using the computer mouse 50% of that time. Her workload has increased 2 to 3 hours per day (overtime) due to staffing shortages over the past 6 months. She denies any significant medical history or trauma to the cervical spine and her cervical x-rays are unremarkable. She reports a small improvement in her symptoms over the last week since she started taking a nonsteroidal anti-inflammatory medication and a muscle relaxant prescribed by her family physician. She states that her physical activity level (e.g., exercising or participating in recreational sports) has declined the past 2 years due to her busy schedule.

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Based on the patient's diagnosis, what do you anticipate may be the contributing factors to her condition?

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What are the most appropriate physical therapy outcome measures for neck pain?

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What are the most appropriate physical therapy interventions?

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What are possible complications interfering with physical therapy?

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What are the concerns regarding the pain radiating into her arm and shoulder?

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ELONGATED MUSCLE: Lengthening of a muscle secondary to being in a sustained elongated position for prolonged period of time

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ERGONOMIC INTERVENTION: Workstation assessment performed to determine risk of injury and/or symptoms, followed by implementation of workstation modifications to decrease musculoskeletal symptoms

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FORWARD HEAD POSTURE: Position of the head is markedly anterior to an imaginary line bisecting the glenohumeral joint in which the mid- and lower-cervical spine are flexed and the upper cervical spine is extended

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MYOFASCIAL TRIGGER POINT: Knots or nodes that form within a taut band of muscle or at myotendinous junctions

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NEUROMUSCULAR CONTROL: Integration of peripheral sensations relative to joint position and processing this information into an effective efferent motor response

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POSTURAL NECK PAIN: Pain associated with sustained static loading of the cervical spine and shoulder girdle during occupational or leisure activities

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POSTURE: Segmental alignment of the body at rest or in equilibrium and the forces ...

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