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Case Study 4

“E.G.” is a 64 year old, right-handed, female, lawyer.

History:

“E.G.” presents with an approximate 32-month history of intermittent neck pain and loss of range of neck movements. The pain is triggered primarily by sudden forces through the neck or by movements of the neck.

X-rays of the neck were normal.

An MRI showed at C5/6 an evidence of a disc bulge and moderate disc height loss, with the focal left postero-lateral and foraminal disc herniation causing significant left neural foraminal stenosis. At C6/7, a moderate disc bulge and disc height loss was noted, but with only slight narrowing of the central spinal canal and mild narrowing of the neural foramina bilaterally.

Physical Examination:

The movements of the head and neck were tight and stiff. “E.G.” was unable to attain full range in either direction on rotation. She attained about 70% of the range on rotation to the right, and only about 30% on rotation to the left. Similarly, she was unable to attain 50% of the range in extension. She was able to bring her chin to her chest and could do normal lateral tilting, however. Palpation of muscle structures revealed abnormal tightness and tenderness in both upper trapeziis (especially on the left side)

Previous Therapies:

• Massage therapy treatments were temporarily effective in pain relief.
• Acupuncture treatments were temporarily helpful in managing the pain.

Diagnosis:

She has a soft tissue injury. The major soft tissue affected is muscle and the locus of the neck and upper shoulders (upper trapezius).

Pulsed Signal Therapy (PST):

Pain Scale:

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