1. Discuss the condition/diagnosis in terms of basic information, pathology, phases of healing.
• 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.
2. Identify
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• Cervical Traction: decompression of the nerve roots to relieve pain and altered sensation
• Cold Pack: Used to diminish physiologic functions such as blood flow, inflammatory response or muscle activity
5. Identify therapeutic goals as appropriate (indications) for your patient needs for each modality identified.
• TENS: Increase ROM, decrease muscle weakness and pain
• Cervical Traction: decompress the nerve roots
• Ultrasound: Soft tissue repair, Trigger points, chronic pain,
• EMG biofeedback: Can be utilized to receive information related to motor performance, kinesthetic performance or physiological response
6. Indicate each physical modality treatment parameters and include supportive statements for your choice of these parameters.
• TENS (Parameters): frequency 50 to 200 pps; pulse duration of 50 to 100 msec; uses the gate theory mechanism and has fast pain relief.
• Cervical Traction (Parameters): Acute/ 1st session- 6 to 10 lbs., static pull, 5 minutes, gradually increase to patient tolerance. Routine Session- 20 to 30 lbs. or 7% of the patient’s body weight, intermittent pull- 15/15, Time: 20 minute. This treatment will distract the joints in the cervical region and help alleviate the pain.
• EMG biofeedback (Parameters): EMG signals need to be amplified
- gain = amplification factors, decrease noise EMG signal usually between
HPI: Ms. Smith presents to the office with bilateral shoulder stiffness and lateral elbow pain in right arm. The patient has been suffering shoulder stiffness for over 2 years. The symptom developed gradually after she started using her computer more at her work place; she had to hold her telephone between her shoulder and head while typing information on computer. The pain in right elbow stated about 8 months ago with gradual onset. The patient does not recall any trauma to the shoulder and elbow. She has been diagnosed as tennis
When it affects your neck, it takes place in the top seven vertebrae in your spine, known as the cervical spine. Over time, or if you suffer an injury, your discs can break down. Oftentimes, the proteins contained within the disc space can cause a good amount of inflammation, which can result in pain, tingling, and numbness in your neck, shoulders, arms, and even hands.
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.
On examination of the cervical spine, there is tenderness and tight muscle band is noted on both the sides of the paravertebral muscles. There is pain with extension and palpation of right facets.
One common cause of neck pain that is progressive in nature is a herniated disc. At the very least, a herniated disk will require intervention by a specialist that deals with corrective procedures concerning the spinal column, and in the worst case scenario, there may be a need for surgery. If left untreated, a herniated disc will intensify in the level of pain that it causes. It will also limit mobility. As the body attempts to make adjustments to compensate for the pain and weakness that is common with herniated disks, it increases the chance of additional injuries in other areas.
DOI: 6/23/2015. Patient is a 44-year-old male assembler who sustained injury while he was reaching for a part, pulled axle from rack and felt pain in the cervical spine. Per OMNI, the patient is diagnosed with acute cervical sprain and cervical radiculopathy.
Biofeedback is sometimes a very confusing topic. It refers to the use of electronic, medical devices to give more auditory, verbal, and visual information back to the body about how it is working. For example, during biofeedback when a person tries to relax his muscles, he can hear a sound telling the degree of relaxation. Or if a person is to slow his pulse, he can hear or see his pulses more easily than by just feeling the pulse. By hearing the pulse, it is easier to try to manipulate it with his conscious control. This is also done with temperature control. When people are nervous, their hands might get colder or sweaty and warmer.
During this reporting period, multiple calls were placed to and received from Mr. Nauka’s sister, Cindy and to Mr. Nauka for general updates on Mr. Nauka’s status and confirming upcoming appointments. Mr. Nauka reports he continues to have pain to his lower stomach, neck and back. Mr. Nauka continues to have good and bad days. Mr. Nauka feels that the H-wave and massage therapy helps loosen his back and neck. On worst days his pain is a “7-8” and after treatment he rates his pain reduction to a “3-4” on the 1-10 pain scale. Mr. Nauka currently has massages twice a month.
In clinical practice a broad spectrum of therapy approaches is being used, ranging from pharmacological, physical agents to exercise and manual therapy practice.
In the article, Assessment of the Cervical Spine Range of Motion After the Use of the Saunders Traction Device in Different Positioning of the Upper Extremities, cervical spine complaints are seen to be increasing due in part to our society becoming more health aware.1 The pain begins with increased tension or stiffness in the muscles of the posterior neck, with varying levels of pain that begin to spread to other areas of the body over time. The positioning of the head towards protraction, pushing forward the shoulders, and an increase in spine inclination is the cause of the pain. If this pain goes untreated, range of motion of the area will decrease, resulting in an overload of other areas attempting to compensate for the injured site. These
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 patient, Miss Tedo, is a 69-year-old female with a diagnosis of cervical degenerative joint disease, also known as cervical osteoarthritis or neck arthritis. Miss Tedo complains that she has neck stiffness and pain rated as 6/10. Miss Tedo also reported that she has tingling and pain rated as 5/10 that radiates down the right arm to the little finger. Upon her visit to the clinic, Miss Tedo presented with limited cervical range of motion, 30o of rotation bilaterally and 10o of lateral flexion bilaterally. She exhibits moderate cervical paravertebral muscle hypertonus with a forward flexed posture and poor postural awareness.
In two weeks the patient will have increased left cervical rotation from 50 degrees to 60 degrees to facilitate driving a forklift at
Cervical spondylosis, also known as cervical osteoarthritis or neck arthritis, is a common, age-related condition that affects the joints and discs in your neck. It develops from wear and tear of the cartilage and bones found in your cervical spine, which is in your neck. While it’s largely due to age, it can be caused by other factors as well.
The Transcutaneous electrical nerve stimulation or TENS is used to help with pain. It is applied using various waveforms and a variety of other electrical stimulation parameters. There are three main types of TENS to choose from. There is conventional TENS, Low Rate TENS, and Burst mode TENS. Conventional TENS is also known as high rate TENS. It uses short duration high frequency pulses at a current amplitude sufficient enough to produce a comfortable sensation without muscle contractions to help with pain.3 High rate can be applied for 24 hours at a time with a rate of 80-100 pps. Also