Study Design: Case series. Objective: To describe the clinical outcomes of 15 patients with cervical radiculopathy treated with mechanical intermittent cervical traction. Background: Effectiveness of traction for the treatment of cervical spinal syndromes is controversial and the outcome of this treatment has not been established in the literature. Methods and Measures: Fifteen patients (45.5 ± 13 years) completed a course of treatment using mechanical intermittent cervical traction. Eleven patients presented at baseline with radicular symptoms of 12 weeks duration or less, and 4 patients had long-standing radicular symptoms lasting more than 12 weeks. Outcome was measured using the Neck Disability Index (NDI) and the Numeric Pain Rating Scale (NPRS). Results: Eight of the 15 cases (53%) in this series demonstrated complete pain resolution; these patients had symptom duration of 12 weeks and less. Seven of these 8 cases displayed a final NDI of 10% or less. Three out of 4 of the patients with symptom duration less than 12 weeks showed no reduction in pain or increased pain rating, with minimal change in perceived disability of 12% or less. Conclusion: In this case series, patients with radicular symptoms lasting for 12 weeks and less demonstrated a reduction in pain and perceived disability. The NDI, when used in conjunction with the NPRS, provides a more comprehensive assessment of the patient with cervical radiculopathy, thus allowing the clinician to make a better judgment about the clinical effects of cervical traction. J Orthop Sports Phys Ther. 2001;31(4):207-213. Key Words: disability, neck pain, traction, treatment outcome

Headache presents a diagnostic challenge for the physical therapist due to similarities of signs and symptoms among the many types of headache. Effective treatment depends upon accurate diagnosis and identifying the factors that may precipitate or perpetuate the symptoms. This commentary overviews some common forms of headache and specifically addresses cervical headache as a possible beneficiary of physical therapy intervention. Details of the history and physical examination, which is designed to diagnose cervical headache and rule out potential serious pathologies, are presented. Guidelines for treatment of articular and myofascial dysfunction are presented. A case report illustrating principles of examination, inherent ambiguities in diagnosis, and successful treatment is also presented. J Orthop Sports Phys Ther. 2001;31(4):184-193. Key Words: headache, migraine, myofascial dysfunction, vertebral joint dysfunction

Spinal instability is a major cause of neck pain, but unfortunately the concept of spinal instability is often ambiguous and poorly defined. For clarity, instability will be referred to as clinical instability throughout this paper. Clinical instability is defined as the inability of the spine under physiological loads to maintain its normal pattern of displacement so that there is no neurological damage or irritation, no development of deformity, and no incapacitating pain. This paper reviews the kinematics and stabilization system of the spine and discusses the etiology, symptoms, diagnosis, and treatment options for cervical spine clinical instability. A case report of a patient with cervical spine clinical instability is included to illustrate its presentation and management.

J Orthop Sports Phys Ther. 2001;31(4):194-206.

Key Words: spinal instability