Whiplash
Usually this occurs as a result of a motor vehicle accident (MVA). The neck is exposed to a sudden deceleration force resulting in hyper extension of the spine. This results in significant soft tissue damage including torn muscles, damage to nerves, ligaments and in some cases the disc is affected. Research has shown that” hairline fractures” of the facet or vertebrae can occur(L.Toomey 1994). The treatment protocol may involve acupuncture, manual therapy, massage therapy together with strengthening and stabilization program supervised by a kinesiologist produces long term effective results.

Tension headaches
May develop as a result of muscular imbalance of the upper neck. This condition is typically secondary to the other musculoskeletal problem, therefore it is crucial to determine the source of the problem and treat it accordingly. We find the use of acupuncture along with manual decompression techniques as the most successful combination in treating tension headaches.

Migraine
Severe unilateral (1 sided) head pain often charactered by sensitivity to light and nausea. Trigger factors include fluctuation in serotonin, certain chemicals such as food colouring, MSG, sulphates and nitrates, together with hormone fluctuation and behavioural issues such as lack of sleep and stress. Treatment includes the use of acupuncture to regulate the endorphin and serotonin balance together with manual therapy and postural re- education. In most cases a therapeutic exercise home program is prescribed.

Postural problems
One of the most common postural problems is characterized by a forward shift of the head relative to the shoulders. It results in elongation and weakness of the front muscle (deep neck flexors) and tightness and spasm of the posterior neck muscles. The key for the successful treatment is an accurate postural analysis and further correction by using Postural Re-educational protocols as well as a combination of acupuncture, manual therapy, active exercise, massage therapy and in some cases spinal decompressions (or traction).

Disc herniation and Osteoarthritis
Common diagnosises used in the patient’s age group of 50+. It will be normally confirmed by the degenerative changes findings on the x-ray, CT scan or MRI. Typical symptoms for the patients with these conditions will be moderate to significant limitation of the movement in the neck, pain “tingling” or numbness referred down the arm, and/or tension headaches. In some cases disc protrusion may lead to significant weakness of the arm. These cases may require consultation of the neurosurgeon. Physiotherapy goal will be to manage the pain and regain neck function as much as possible without aggravating the symptoms. Our treatment protocol will include extensive use of manual therapy techniques, acupuncture, electrotherapy and exercises.

Post surgical conditions
In some cases when prolapsed disk leads to surgery, and affected joints are subsequently fused, the Post surgical physiotherapy is crucial to a positive long term outcome. The treatment will include mobilization of scar tissue using manual therapy techniques, electrotherapy, and exercise programs as well as strengthening stabilization program implemented by the kinesiologist and supervised by the physiotherapist.