REMEMBER THE DTM FLOW…
1. Identify provocative movement
2. Consider involved neurology for potential neuropathic component
3. Assess for neural sensitivity
4. Apply treatment to improve mechanical interface of the involved neuro
5. Re-test provocative movement
6. Apply homecare and perform regularly until sensitivity to movement normalizes
Common Diagnosis
- Cervicalgia
- Rotator cuff tear
- Shoulder arthritis
- Spondylosis
- Spinal arthritis
- Whiplash
Target Neurology
- Dorsalscapular nerve
- Posterior ramii nerves
We have found excellent benefit from considering upper back pain from a McKenzie perspective. If cervical extension causes pain in the upper back and mid-scapular areas, suspect joint derangement classification in the cervical spine and evaluate for it. For those that utilize spinal manipulation, skin rolling of the upper back for sensitization along the course of the posterior ramii may help to localize involved segments. We have found great benefit in pain in the upper back with neck flexion when we consider the possible involvement of the dorsalscapular nerve and use DTM on that pathway.
