Cervical Radiculopathy Case Study

Additionally, a physical therapist may apply cold and heat packs and recommend deep-tissue massage to reduce neck pain. Your PT may have you work through your exercises while standing in front of a mirror to make you aware of maintaining good posture, another element that can benefit a cervical disc condition.

Cervical degenerative disc disease is a common cause of neck pain and radiating arm pain. It develops when one or more of the cushioning discs in the cervical spine starts to break down due to wear and tear. There may be a genetic factor that predisposes some people to more rapid wear. Injury may also contribute and sometimes can cause the development of the degenerative changes. When cervical degenerative disc disease becomes indicated, the pain might develop slowly over time or appear suddenly. The signs can range from mild annoying neck aches to debilitating pain, numbness, and/or weakness that radiates into the arm and hand.

1. Cervical adjustment: It is the manual treatment for the people suffering from neck and shoulder pain. The practitioner stimulate the joints position to improve the functioning of the nervous system.

Based on the latest medical report dated 02/10/16, the patient has undergone extensive PT. She was diagnosed with sprain/strain derangement of the cervical spine, cervical subluxation complex, and cervical brachial radiculopathy, sprain/strain derangement of the lumbar spine, lumbar subluxation complex and lumbar radiculopathy.

Sample: 81 participants diagnosed with cervical radiculopathy from multiclinic sites were placed into two groups. The participants were selected based on their age (between 18-70), whether they were experiencing pain, paresthesias, or numbness in the upper extremities, a diagnosis of cervical

DOI: 2/19/2014. Patient is a 53-year old right-hand dominant female production worker who sustained injuries to her neck, low back, right shoulder, and bilateral knees as a result of cumulative trauma. Per OMNI entry, she was initially diagnosed with cervical radiculopathy, lumbosacral radiculopathy, bilateral shoulders tendinosis/bursitis and knee tendinosis/bursitis.

Due to the cause of this headache type being primarily musculoskeletal in nature, different manners of physical rehabilitation are often utilized. A research article published by the journal BMC Musculoskeletal Disorders studied the effects of upper cervical and upper thoracic manipulation versus mobilization and exercise in patients with cervicogenic headaches (Dunning et al., 2016). The results of the study propose that six to eight sessions of manipulation directed to both upper cervical (C1-C2) and upper thoracic (T1-T2) spinal levels were shown to be more effective than mobilization and exercise alone (Dunning et al., 2016). Individuals in the study experienced reductions in headache intensity, disability, frequency, duration, and medication intake; effects were maintained at a 3 month follow up. While encouraging, the study did present with some limitations, such as it is not known if the effects would have been maintained long term. Another limitation is that multiple secondary outcomes were included in the study, and that the results may not be generalizable to other kinds of manual therapy techniques. However, this study may provide evidence that the management of cervicogenic headaches should include some form of cervical manipulation (Dunning et al.,

Cervical arthritis is a condition that develops in the upper parts of the spine and neck. This is a very painful form of arthritis that affects a number of people. This form of arthritis may develop due to age, but it can also be the result of injury. Fortunately, there are specific treatment options for this form of arthritis.

Agony can be a indication in some people but myelopathy generally is non-painful, as the spinal cord has no pain receptors. Neck pain can be present as a result of the degenerative changes that cause spinal cord compression. When Myelopathy often presents with a rapid deterioration of walking ability. They

As a result, a discomfort in the arm from a cervical herniated disc may arise because the herniated disc fragments compresses or crushes on a cervical nerve that causes the pain to emit along the nerve pathway going down the arms. Together with the pain in the arms, numbness and burning sensation can show up in the arm going down to the fingertips. Weakness in the muscles may also arise. The discs along the cervical spine are not very big; however, there is not much of a space accessible for the nerves. This connotes that even a tiny cervical disc herniation may infringe on the nerve and be the source of significant pain. The pain in the arm is commonly most serious as the nerve becomes tweaked.

The most relevant findings from the objective exam lead me to diagnosis the patient with a left sided C5 disc pathology causing secondary radiculopathy symptoms. Nerve roots should normally be able to withstand relative mechanical insults such as compression and stretching.4 Nerve roots can become injured in a multitude of ways including decreased space in the intervertebral foramina or spinal canal secondary to osteophytes or other degenerative changes from nearby structures such as facets or uncovertebral joints which can cause compression on the nerve root in “closing” type movements4. Other methods include herniated discs, synovial cysts or alterations in the chemical environment around the disc.5 Damage to the nerve root can cause sensitivity changes, hyporeflexia and motor weakness in the segment supplied by that specific nerve root. In this patient’s case the C5 nerve root was most indicated because it supplies the anterior shoulder dermatome, motor strength for shoulder abduction and biceps reflex. I believe the peripheralization of the patient’s symptoms laterally down the left shoulder and upper arm is caused by an increase in mechanosensitivity in which “pressure and/or stretch on a nerve produces immediate symptoms.6” When the patient decreases space and potentially compresses the nerves ie., cervical extension, lateral flexion to the left side and rotation to the left side his symptoms are peripheralized and the pain increases. The pain generators at the nerve root with increased sensitivity to these closing movements are referred to as

Neck pain is a common condition, ranking as the fourth most burdensome disease worldwide. Evidence suggests that rates of recurrence and chronicity are high (Borghouts et al, 1998; Hoving et al, 2001), which results in considerable functional and economic implications (Vos et al., 2010). Joint mobilization (JM) is widely acknowledged as an effective intervention (Childs et al., 2008); and the UPA is an entry-level form of JM commonly used by physiotherapists globally. However, a Cochrane review indicated that the most effective cervical JM dosage has yet to be determined (Gross et al., 2010). Unilateral anterior glide (UPA) appears to be more efficacious for pain relief and outcomes in patients with unilateral neck pain compared to other JM techniques (Egwu, 2008). The rationale behind the pain modulation attained with JM has been suggested to be as a result of neurophysiologic mechanisms (Bialosky et al., 2008). For example, spinal manipulative therapy has been associated with increased afferent discharge (Colloca et al., 2003), motoneuron pool depression (Dishman et al., 2005), changes in motor activity (Herzog, 1999; DeVocht, 2005) and reduction of pain perception in response to a standard stimulus (George, 2006; Vicenzino, 1996). The neurophysiologic system that alters pain overlaps with blood pressure (BP) as observed in BP-related hypoalgesia (Vincenzino, 1998; Sterling, 2001). Therefore, BP is a pertinent and easily quantified variable to examine to ensure

ES is suffering from recurring neck pain with the head persistently turn to one side. Last year she had gone for a detailed medical examination and the doctor confirmed that she is suffering from cervical dystonia. Sometimes, she got to take botulinum toxin injections and other times Norco 5 / 325 PRN, to ease spasms and pain. She is seeing a chiropractor also. Currently she is not having any neck pain.

Some reasons I would likely refer for C5 radiculopathy would be if the patient has a fracture. Unexpected weight loss, or history of cancer. Fever, chills, night sweats, or known drug use. If symptoms resonate in the lower extremities as well causing bowel and bladder dysfunction. Severe limitations during AROM in all directions of neck. Drop attacks, dizziness, and lightheadedness due to neck movement. Positive cranial nerve signs, and blood pressure about 160/95 mm Hg. Resting HR over 100 BPM and resting respiration rate over 25 bpm. Sever fatigue. If you are unable alleviate any symptoms within 2 weeks.

Mr. Anderson continues to report subjective pain levels that exceed 10 even with medication adjustments. He now is reporting severe cervical pain that required an emergency room visit. He has been treating with Dr. Rampersaud for the cervical pain, staff continues to be updated that it is not related to the work injury and keep billing accordingly. Mr. Anderson has also been evaluated by his family doctor regarding kidney stones. He has a history of kidney stones and with the rib pain, they wanted to rule out kidney stones. All tests were negative. He will continue to have a consistent reduction of pain medications at each medical appointment with Dr. Rampersaud. Mr. Anderson has started and failed physical therapy. He had the permanent spinal