Why does my Physiotherapist ask me so many questions when I have Neck Pain or Headache?

What is Vertebrobasilar Artery?

It is surprising how many people have neck pain. The number of people with chronic neck pain at any one time (i.e. the point prevalence) is over 2 per hundred (2%) in some western countries. Even more alarming is that about 5% of adults have neck pain of some sort at any point in time. During any 6 month period, over 50% of individuals will have experienced neck pain. Causes of neck pain include trauma, stress, poor ergonomics at work, and painin the shoulder.

Many will seek pain relief from their local physiotherapist for their neck pain. We treat people with neck pain and/or headache almost every day.

What is the Treatment for Neck Pain?

Physiotherapy treatment delivered by IceFire Physiotherapy may include mobilisation of the joints and soft tissues (massage), dry needling, therapeutic ultrasound, a home program of strengthening exercises, and ergonomic advice. One of our physiotherapists is fully qualified and experienced in remedial massage.

Why do Physiotherapists Assess Integrity of Neck Structures?

Regardless of the treatment option employed it is important that as physiotherapists we assess the integrity of your various neck structures, as there may be a structural problem that you are not aware of. Although this hidden pathology may not be causing any neck pain, it still may be placing you at risk of serious illness, even if you do not have neck treatment.

One of the structural problems that can lurk is called vertebrobasilar artery insufficiency, (VBI). This artery twists and turns along its path through the neck and the base of the skull, at some points the artery can become damaged or narrowed, and this can cause a decrease in the amount of blood delivered to the brain. Significant decreases of blood flow in the brain is called a stroke, and one of the most common causes is blood clots. In Australia, there are around 56,000 new and recurrent stroke events every year – that is one stroke every nine minutes. Around 30% of stroke survivors are under the age of 65.

What are Symptoms of verterbrobasilar artery insufficiency (VBI)?

Symptoms of verterbrobasilar artery insufficiency (VBI) include dizziness, double vision, problems with swallowing (called dysphagia) and numbness of the face and tongue. VBI can arise when you are not moving your neck in a manner particularly different to normal.

Because of this, at IceFire Physiotherapy we will ask you a series of questions that will help us discern if you have a high probability of having problems with your vertebrobasilar artery.

The following questionnaire is based on one presented in a course for physiotherapists, led by Professor Dr Duncan Reid, and held at the University of Queensland.

If you have an upcoming appointment with IceFire Physiotherapy for neck pain, then it is possible that one of our physiotherapists will request that you complete this questionnaire.

The questionnaire can be completed in less than 3 minutes for most people.

Alternatively you can download a copy of the questionnaire here and print it. On the day of your consultation, answer the questions as best you can before your appointment. There is no need for you to sign it – your physiotherapist will ask you to sign it during your consultation.

We understand that you may not wish to answer all of the questions. You can read our privacy policy here.


  1. AP Goode, J Freburger, T Carey, Prevalence, Practice Patterns, and Evidence for Chronic Neck Pain, Arthritis Care & Research, Vol. 62(11), November 2010,
  2. Physiopedia, Epidemiology of Neck Pain,
  3. Stoke Foundation, Facts and figures about stroke.

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