Neck Pain Disorders & Disability

(Regional Application of the Duffy-Rath System©)

Brief Description of the Course:

The Duffy-Rath System© (DRS) is a unique approach to the assessment, treatment and prevention of musculoskeletal disorders (MSD) and disability. Developed in 1984 by Wayne and Jean (Duffy) Rath, the system is currently utilized at outpatient clinics and industrial sites across the United States and internationally. This workshop provides the clinician with a system to improve their effectiveness and efficiency in assessment and treatment of activity-related back pain disorders; all treatment strategies are oriented towards recovery of activity tolerance and long-term self-efficacy (i.e. secondary and tertiary prevention).

This workshop has an online and a live component. The online component must be completed prior to attending the live workshop; this involves successfully completing an ‘open-book’ test. The live workshop is a 1-day format with a focus to treatment strategies, procedures and problem-solving techniques specific to the most common neck/upper back pain diagnoses and relevant classification systems.

Pre-requisite to Registering for this Workshop: Evidence of successful completion of the online course entitled; “Introduction to the Duffy-Rath System©: Linking treatment and prevention for musculoskeletal self-efficacy” is required to register for this workshop.

Workshop Goal: Promote a systematic, prevention-oriented and non-operative approach to the assessment, treatment and prevent of activity-related neck/upper back pain disorders and disability that is effective, efficient, accountable and long-term focused.

Workshop Instructional Objectives – upon completion of this activity, participants will be able to:

1. Identify relevant epidemiology for neck pain disorders including; natural history, risk factors for onset and disability and apply to a treatment plan focused to musculoskeletal self-efficacy.
2. Identify anatomy, biomechanics and pathological processes relevant to clinical management of the activity-related neck/upper back pain disorders – including accuracies of diagnostic imaging.
3. Identify the distinguishing clinical characteristics, appropriate treatment strategies and key therapeutic procedures for the most common lower cervical/upper thoracic disorders seen in physical therapy practice (non-specific and specific pathoanatomic) and cervicogenic headache.
4. Able to perform basic manual therapy procedures appropriate to the neck/upper back pain disorders.
5. Identify the most common cautions and contraindications related to neck/upper back pain disorders and methods for rapid identification.
6. Identify the role of objective assessment of function, surgery and alternative methods of healthcare in the treatment and prevention of neck/upper back pain disorders and disability.

Workshop Schedule:


Online Registration and Orientation Participants register online and are orientated to the structure and process for completing the online component.
Epidemiology: Neck Pain Incidence, prevalence, risk factors (onset, occupational reporting and disability distinguished), natural history, socioeconomic impacts and the growing issue of iatrogenic disability.
Anatomy & Biomechanics Review of relevant neck/upper back anatomy, biomechanical and physiological responses to movement and loading under normal and pathological conditions.
Diagnostic Imaging Review of the diagnostic accuracy of x-rays, CT scans and MRI relevant to neck pain disorders.
Diagnostic Imaging Review of the diagnostic accuracy of x-rays, CT scans and MRI relevant to LBP disorders.
Degenerative Spondylosis Review of the process and stages of degenerative spondylosis, including: changes in the intervertebral disc, zygapophyseal joints, neural arch, canal and foramen.
Non-specific Low Back Pain Review and identification of this large group of patients and evidence-based sub-groups.
Intervertebral Disc Disorders  Review and identification of contained verses non-contained activity-related disc disorders.
Nerve Root Disorders Review and identification of nerve root entrapment and adherence of intervertebral discal origin.
Cervical Spinal Stenosis Review and identify foraminal encroachment due to degenerative spondylosis.
Other Activity-related Cervical Pathologies  This section reviews and identifies muscle/tendon, ligament, zygapophyseal and thoracic outlet disorders.
Role of Injections and Surgery Review of efficacy for select groups of patients; i.e. specific clinical diagnoses verses degenerative spondylosis.
Objectifying Neck/upper back Function and Ability Role of physical abilities testing, functional capacity evaluations and functional demand evaluation in treatment and prevention of LBP disorders and disability.
Long-term Planning The role of self-efficacy in long-term management, preserving physical ability and preventing disability.
Basic Neck/upper back History & Exam Outline of the basic history and examination utilized in the Duffy-Rath System©.
Test Open-book test; 20 multiple choice questions – 80% passage required, multiple opportunities (i.e. as many as needed) provided.
Study Time 4 – 8 hours is expected to complete the online section of the course


Live Portion of Course (>50 PowerPoint Slides and 13 pages of evidence support)
Time Regristration Brief Description
8:30 Regristration Participants sign-in again (required for course certificate).
9:00 Introduction Review of online material, identification of the sub-groups of NSLBP and specific low back pathologies to be addressed in the workshop.
9:30 Cervical Derangement Syndrome Review distinguishing clinical characteristics and sub-groups of the Cervical derangement syndrome.Palpation and landmark identification for manual techniques and diagnosis of the level of derangement.Review evidence required to establish that reduction has been achieved.
10:45 BREAK  15 minutes
11:00 Cervical Derangement Syndrome Continued Practice 3 groups of manual and therapeutic techniques to achieve reduction: extension, rotation/lateral flexion and flexion.Discuss strategies to maintain and stabilize reduction, recover full function and prevent recurrence.
12:30 Lunch  30 minutes
1:00 Neck/upper back Soft-tissue Disorders Identify distinguishing clinical characteristics of muscular and ligament disorders.Practice manual techniques for the most common soft-tissue disorders.
1:45 Nerve Root Entrapment and Adherence  Identify and discuss distinguishing clinical characteristics of a stable nerve root entrapment and adherence of discal origin; i.e. ready for remodeling.
2:30 Cervical  Spinal Stenosis Identify distinguishing clinical characteristics of cervical spinal stenosis and practice manual (flexion-based) techniques.
3:15 Upper Cervical Exam Identify and practice examination procedures that localize a activity-related disorder to be located at C2-3 or higher.
3:45 BREAK  15 minutes
3:45 Upper Cervical Techniques Practice the most commonly effective upper cervical manual and therapeutic techniques and discuss therapeutic strategies.
4:30 Cautions & Contra-indications Review and discuss the most commonly encountered cautions and contraindications.
4:45 Summary, Critiques & Certificates Summarize the online and live components; provide direction for further information and training.Certificates awarded after critique is submitted.
5:00 Conclusion
8 hours – 1 hour 7.0 Contact Hours (Total 11 hours)