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Neck Pain Care Pathway

Date of last update: February, 2024

Report of Findings (ROF)

Clinical Cornerstone:

  • The ROF aims to educate the patient about their condition, set a common understanding of expectations, and build trust. It's essential to communicate effectively, using language that the patient can comprehend, and to create an environment where the patient feels comfortable asking questions and participating in their care. Depending on the patient, it may be necessary to involve family or caregivers at this stage.

1. Review of Patient's History: Summarize main complaints, concerns, and relevant history.

2. Clinical Examination Findings: Discuss key results that shaped your understanding or care planning.


3. Diagnostic Results: If applicable, explain imaging or test results in plain language.

4. Diagnosis: State the diagnosis and explain contributing factors through a biopsychosocial approach, particularly for persistent neck pain cases. This should include reviewing any yellow flags  identified. It may include summarizing the following sections of their History Assessment as well: Narrative (how the issue affects their daily living, PSFS), Social History (support system), Social determinants of health (occupational or domestic stressors), Lifestyle (exercise, nutrition/smoking, stress) . It may also include summarizing relevant outcome questionnaires (e.g. NDI).

5. Prognosis: Outline the expected course, discuss negative prognostic factors, and provide an anticipated recovery time.


6. Treatment Recommendations: Engage in shared decision-making  for the management plan treatment goals and expected outcomes. Discuss benefits and risks of treatment, discuss alternate treatment options (e.g., medication, CBT, self-management only, treatment with other providers/disciplines), explain any proposed interventions (e.g., manual therapy, exercises, modalities) and how they fit with the agreed treatment goals and expected outcomes.

7. Patient's Role in Recovery: Engage conversation emphasizing the importance of patient involvement and self-management; suggest home exercises, lifestyle modifications, behaviour changes, and any other self-care measures; emphasize adherence to recommendations.

8. Address Concerns and Questions: Encourage patient queries and provide clear answers.

Conclusion: Summarize the ROF and emphasize collaborative care.

Documentation: Record all findings, discussions, and recommendations in the patient's record.

Conduct patient assessment

Red flags present

Red flags present

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Refer to appropriate emergency or healthcare provider

  • Structured patient education

  • Exercise (strength, range of motion)

  • Manual therapies (e.g., spinal manipulation or mobilization, massage)

  • Low-level laser therapy

  • Psychological / social support

  • Medicines

  • Referral

Major symptom/sign change

Goals not achieved


Adjust treatment and management plan or refer

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These care pathways are intended to provide information to practitioners who provide care to people with musculoskeletal conditions. The care pathways on this website are 'living' documents, reflecting the state of clinical practice and research evidence to our best knowledge at the time of development. As knowledge and healthcare practices evolve, these pathways may be updated to ensure they remain current and evidence driven. These pathways are not intended to replace advice from a qualified healthcare provider.

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