Diagnosis and clinical approach.
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CERVICAL AND LUMBAR RADICULOPATHY:
DIAGNOSIS AND CLINICAL APPROACH
CPD COURSE PLAN
This is a largely didactic course with enhanced student interaction in 4 modules:
Module 1) Cervical Radiculopathy: definition and differential.
Module 2) Cervical Radiculopathy: a safe clinical approach for manual therapists.
Module 3) Lumbar Radiculopathy: definition and differential.
Module 4) Lumbar Radiculopathy: a safe clinical approach for manual therapists.
Course times: 09:00 to 17:00
CPD POINTS: 8
REFRESHMENTS depend on the venue. Some have the facilities others do not.
VENUE: Most frequently, the venues will be the North London School of Sports Massage and the NTC (National Training Centre, Dublin).
EQUIPMENT REQUIRED: None
EXTENSIVE NOTES WILL BE PROVIDED ON A FREE USB STICK.
CERVICAL AND LUMBAR RADICULOPATHY
DIAGNOSIS AND CLINICAL APPROACH
AIMS AND OUTCOMES
Module 1) Cervical Radiculopathy: definition and differential.
Module 2) Cervical Radiculopathy: a safe clinical approach for manual therapists.
Module 3) Lumbar Radiculopathy: definition and differential.
Module 4) Lumbar Radiculopathy: a safe clinical approach for manual therapists.
Learning Aims:
Modules 1 & 3: To revise, refresh and re-familiarise the attendee with the concepts and details of this complex condition in a way which simplifies and de-mystifies, thereby reducing therapist-anxiety and increasing patient safety.
Modules 2 & 4: To outline a simple and rational framework by means of which the therapist can make a clear and informed decision whether to treat or refer and provide them with the tools to understand how indirect techniques may be used to alleviate symptoms in less severe cases.
Learning Outcomes:
By the end of this course, the participant should:
Be able to recognise these conditions.
Be able to differentially diagnose radiculopathy from the multitude of other conditions and pathologies causing similar symptoms thus improving patient safety.
Have a clear understanding of the aetiology and underlying anatomy behind these radiculopathies.
Be able to offer a rational argument for either safe, conservative treatment or referral.
Have a clear understanding of what a conservative treatment approach should look like and how to implement it without risk to the patient.
Be far less anxious as well as more conscious of patient safety.
Course Duration: One day (eight hours).
CPD Points: 8
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CERVICAL AND LUMBAR RADICULOPATHY
INTRODUCTION
Are you confused about whether or not you are “allowed” to treat or claim to treat these conditions?
Do you feel anxious with a primary presentation of radiculopathy?
Do you simply automatically refer to another practitioner or to a consultant neurologist?
Have you ever put your hands on a patient without a thorough and detailed understanding of what the underlying cause of the complaint actually was?
If so, did you fear for the patient’s safety and your own reputation?
If the answer to any or all of these questions is “yes,” fear no more!
This CPD course will de-mystify what can appear to be a complex and daunting condition and provide you with the tools to come to your own understanding of your patient’s symptoms and make a rational and detailed differential diagnosis so that you can make a clear and logical argument whether to treat or refer.
More than that, you will come away with a clear and simple road-map to a safe and effective clinical approach should you decide it may be possible to alleviate your patient’s symptoms.
David Wilson pulls no punches and, time permitting, will answer any questions you may have during the course as truthfully and honestly as possible.
Make no mistake; patient safety is the primary concern but therapist safety comes a very close second and, in all manual therapies, each is intimately dependant on the other.
A good therapist makes for a safer patient.
Enjoy the course. Yes, it’s serious but it’s also meant to be fun and relaxed in an informal atmosphere.
CERVICAL AND LUMBAR RADICULOPATHY
LESSON PLAN
1)Introduction to the tutor 5 min
2) Introduction to the class 10 min
3) Introduction to the course – what its aims are and what you are about to learn 15min
4) Module 1: Presentation 60 min
5) Discussion and Q&A 60 min
6) Break for coffee and antidepressants 20 min
7) Module 2: Presentation 45 min
8) Discussion and Q&A 60 min
9) LUNCH 30 min
10) Module 3: Presentation 30 min
11) Discussion and Q&A 30 min
12) Module 4: Presentation 60 min
13) Discussion and Q&A 45 min
14) Presentation of attendance certificates
All times are Approximate
CERVICAL RADICULOPATHY
MODULE 1: DEFINITION AND DIFFERENTIAL
WHAT IS RADICULOPATHY AND WHAT IS THE DIFFERENCE BETWEEN RADICULOPATHY, NEUROPATHY AND MYELOPATHY?
Radiculopathy is anything that impinges upon or damages a NERVE ROOT, so the area of deficit will be SEGMENTAL. In other words, we can roughly map it in terms of dermatomes and myotomes and symptoms are LOWER MOTOR NEURON.
Neuropathy is damage to a PERIPHERAL NERVE, so the area of deficit will be whatever is supplied by that particular nerve, NOT SEGMENTAL. Symptoms are LOWER MOTOR NEURON.
Myelopathy is a compression of the SPINAL CORD (eg from a centrally herniated disc, metastatic growth or stenosis of the spinal canal), so symptoms are UPPER MOTOR NEURON.
Myopathy is any pathology that affects one or more skeletal muscles, causing weakness.
AAOS DEFINITION:
Orthodox definitions, including the American Academy of Orthopaedic Surgeons, offer little better definition than “a pinched nerve in the neck,” although the AAOS do go on to say;
“This occurs when a nerve in the neck is compressed or irritated where it branches away from the spinal cord. This may cause pain that radiates into the shoulder and/or arm, as well as muscle weakness and numbness.”
The AAOS list only two causes:
1) Degenerative change.
2) An injury that results in a herniated intervertebral disc.
They then go on to say that it can happen in young, healthy people with no traumatic incident., in other words, ideopathically.
TREATMENT:
According to the AAOS, treatment is listed as conservative, including medication and physical therapy. They state that the condition does not require surgery. This is a contradiction in the case of spondylolysthesis.
