Neck Pain - Cervicogenic

Presenting symptoms

A 58 year-old male was referred to 360 NMT by a Pain Care specialist to investigate the soft-tissue contributions to neck pain and associated tingling sensation into the arm. Prior diagnoses included cervical arthritis, herniated cervical discs, disc debris within the cervical spine, and nerve impingement.

Evaluation, clinical reasoning & treatment strategizing

We conducted a postural assessment and found shortened muscles in the left anterior and right posterior quadrants of the neck. The sub-occipital and pectoral muscles were also shortened. These combined contractions could account for the forward head position (FHP) with right cervical rotation and contributions to cervical nerve entrapment. NMT would focus treatments on decreasing hypertonicity and improving posture to reduce any muscular sourced strain contributing to neck symptoms.

Treatment

NMT sessions were designed to complement the goals of Physical Therapy. After two treatments, cervical rotation had increased by 10 degrees. After seven treatments, rotation was within normal range. His pain reduced from 8 to 0, with less tingling in the arm.  Although lateral flexion improved to 30 degrees during treatment, gains did not hold for longer than a week. He continued his home strengthening exercises and stretches given to him by the physical therapist.

Outcomes and follow-up

Overall, muscular hypertonicity decreased and FHP improved. When osteoarthritis and pre-existing neck history is extensive, NMT might not “fix” everything. However, it can make significant improvements in most soft-tissue driven pain and dysfunction in the neck.