Head and neck pain, moderate following MVA. Treated with chiropractic therapy; symptoms persist with limited further improvement.

Neck and upper back pain since MVA, moderate in severity. Chiropractic care provided partial relief but condition has plateaued.

Upper back and mid-back pain after MVA. Conservative treatment including chiropractic therapy has reached maximal benefit.

Mid-back and lower back pain, moderate post-MVA. Treated with chiropractic therapy; residual symptoms remain without continued progress.

Lower back and sacral pain following MVA, moderate. Chiropractic treatment completed with limited sustained improvement.

Lower back and right hip pain after MVA, including trochanteric region. Treated conservatively; improvement has stabilized.

Lower back and left hip pain with trochanteric bursitis following MVA. Chiropractic therapy provided partial relief but symptoms persist.

Back and bilateral hip pain post-MVA, involving trochanteric bursae. Conservative management has reached a plateau.

Neck pain with associated upper back and shoulder girdle discomfort after MVA. Treated with chiropractic therapy; recovery has stalled.

Head, neck, and upper back pain following MVA, moderate and persistent. Chiropractic care provided limited improvement and symptoms remain unresolved.

EXAMS ... 

CERVICAL / HEAD–NECK

Seated Soto-Hall Test
• Assesses: Cervical disc, posterior elements, ligamentous injury
• Performed: Patient seated; examiner stabilizes sternum while gently flexing cervical spine; pain reproduction considered positive.

Spurling’s Position (No Compression)
• Assesses: Cervical foraminal narrowing, nerve root irritation
• Performed: Patient extends, rotates, and side-bends neck toward symptomatic side without axial load; symptom reproduction noted.

Cervical ROM
• Assesses: Joint mobility and pain patterns
• Performed: Active flexion, extension, rotation, and side-bending observed and compared bilaterally.

Suboccipital / Cervical Palpation
• Assesses: Myofascial tenderness, facet irritation
• Performed: Digital palpation of suboccipital muscles, cervical paraspinals, and facet joints.

THORACIC / UPPER–MID BACK

Thoracic Spring Testing
• Assesses: Segmental joint mobility and pain
• Performed: Posterior-to-anterior pressure applied over thoracic spinous processes with patient prone or seated.

Seated Thoracic Rotation & Extension
• Assesses: Thoracic mobility and pain reproduction
• Performed: Patient seated; active trunk rotation and extension performed while examiner observes symmetry and pain.

Rib Springing
• Assesses: Costovertebral joint dysfunction
• Performed: Anterior-to-posterior pressure applied over rib angles to assess mobility and pain response.

Paraspinal Palpation
• Assesses: Muscle spasm, trigger points, facet tenderness
• Performed: Manual palpation along thoracic paraspinal musculature.

LUMBAR / SACRAL

Lumbar ROM
• Assesses: Disc, facet, and muscular function
• Performed: Active lumbar flexion, extension, rotation, and side-bending assessed in standing or seated position.

Lumbar Facet Loading (Kemp-Type)
• Assesses: Facet-mediated axial pain
• Performed: Patient extends and rotates lumbar spine toward symptomatic side; pain reproduction noted.

SI Joint Compression
• Assesses: Sacroiliac joint pathology
• Performed: Lateral compression applied to iliac crests with patient supine or side-lying.

Seated Neurologic Screening
• Assesses: Nerve root integrity
• Performed: Gross motor strength, sensation, and reflexes assessed in seated position.

HIP / TROCHANTERIC REGION

FABER (Flexion–Abduction–External Rotation)
• Assesses: Hip joint vs SI pathology
• Performed: Supine; ankle placed over opposite knee; downward pressure applied to flexed knee.

FADIR (Flexion–Adduction–Internal Rotation)
• Assesses: Femoroacetabular impingement, anterior hip pathology
• Performed: Supine; hip flexed to 90°, then adducted and internally rotated.

Greater Trochanteric Palpation
• Assesses: Trochanteric bursitis
• Performed: Direct palpation over greater trochanter to reproduce focal lateral hip pain.