AccessPT Channel, Weekly Physical Therapy Conundrum

PT Question of the Week - Pain and Stiffness in the Left Cervical Region

You are evaluating a patient with pain and stiffness in the left cervical region, located at the level of the left C3-4 spinal segment, aggravated by looking over the left shoulder and looking up. Although there is some increased muscle tone in the left levator scapula and upper trapezius muscles, there are no reports of pain, numbness, or tingling in the upper extremities, and the neurological examination is unremarkable. Suspecting a cervical facet joint syndrome, you perform passive intervertebral motion techniques to assess the joint glides. Which of the following joint glides would you expect to find positive for decreased motion?

  1. Posterior glide of C3 on C4 on the left
  2. Anterior glide of C3 on C4 on the left
  3. Anterior glide of C4 on C3 on the left
  4. A and C