Case Study – Pain made her Strong

March 5, 2019 | By | Reply READ MORE...

A 43 year old female came to the clinic with following complaints:

  • Pain in the neck since 8 months.
  • Pain radiating down till the left arm.
  • Inability to perform her daily activities; for ex: holding the phone even for few seconds in the left hand would give her pain and feeling of numbness radiating her arm.
  • Frequent headaches associated with left jaw pain and pain in the left eye. Burning sensation in both the eyes.
  • Giddiness : specially in the morning or while reading her bible. Any position change would give her giddiness; for ex: getting up from the bed, seeing her kids moving around, washing utensils, cooking, etc.
  • Anxiety: she also complained of frequent palpitations, muscle twitching specially her facial muscles.

HISTORY
History of neck pain 8 months back. The tingling and numbness on the face along with headaches had made her more anxious. She consulted a neurologist who advised her to do a Brain MRI which was clear. Her spine MRI showed degenerative changes in her cervical spine. Slipped disc at multiple level along with scoliosis in the neck. Her orthopedic gave her pain killers and she was also given D3, B12 supplements for early healing . No other relevant medical history. She had joined gym few months back and she felt weight lifting aggravated her pain.

WHAT IS SCOLIOSIS?
Scoliosis is a condition in which there is a bend in the spine. There can be multiple reasons for this, most commonly being bad posture(forward neck). Scoliosis occurs at 3 levels: neck, mid- back and low back. The condition is associated with pain, muscle tightness, tingling /numbness/ weakness in the extremities.
There are other conditions which mimic the symptoms of scoliosis like slipped disc(neck/back) or early aging spine(degenerative diseases) etc.

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CLINICAL EVALUATION

  • Posture: Forward neck posture. Rounded shoulder and upper back. Her neck movements, turning to the left and side bending to the left were restricted.
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  • Motor assessment: Muscle strength poor in both the arms, left more than right. Her left grip was poor.
    Balance and coordination: This was assessed to rule out any balance issues as she complained of giddiness. Balance evaluation also involved standing on one leg with eyes closed, walking on an inclined surface, etc. Her balance was compromised cause of the tight neck muscles and reduced neck movement.
  • Pain: She had active triggers in the neck. Her nerve tension test of left hand was positive(this indicates that the slipped disc triggered the nerve supplying the arm which gave her pain radiating the arm. Anxiety also can cause increased tension in the neck muscles worsening the pain and stiffness.

PLAN OF CARE

  1. Take care of the pain: We used pain modalities like TENS and ultrasound to alleviate her pain. Also some techniques like trigger point releases and mobilization helped her neck movement get better and also pain getting better. Also taping helped her support the neck better specially while she was travelling.
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  2. Educate about correct posture: This included educating her about the do’s and don’ts she had to follow and maintaining a correct head-neck posture.
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    Also ideal posture to maintain while doing any sitting or standing activity.
  3. Motor strengthening: This included strengthening her upper back muscles(scapular muscle) mainly, as these being important neck stabilizing muscles. We also worked on the muscles of the neck, biceps, triceps. We used theraband and weights to improve the muscle strength.
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  4. Fitness: Once her muscle strength was fair she was pushed for high intensity work out; for ex; trx, weight training etc.
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  5. Counselling: As she is a wife of a navy personnel, she single handedly had to manage many things; upbringing of her two kids, taking care of her in-laws and other household things. Too much responsibility made her anxious and she noted a change in her behavior. She had become short tempered and emotional. Breathing exercises and yoga helped her to overcome her anxiety. Also as her strength picked up she was more confident in doing things which she before feared of.

Today she is a strong woman handling the house responsibilities with more confidence.
No more aches and pains. Is able to talk on the phone for around half an hour without pain.
Is able to deal with her anxiety.
Feels stronger physically as well as mentally.

She now visits the clinic for her fitness sessions.

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Category: Case Studies

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