Neck dominant pain
A pleasant, active and fit, 32-year-old female administrative assistant, accessed CareChain with a six-month complaint of debilitating neck pain that was insidious in onset. She reported experiencing similar, less intense episodes of neck pain throughout her life, but those episodes only lasted a week or two and would resolve with medication and relative rest. She indicated that her neck had become a significant concern to her recently as it had started to affect her ability to perform her job duties.
Unlike her previous episodes, this current episode had not responded to medication or relative rest. She continues to work at her job, which is comprised of long hours of sitting, typing, and answering telephones. She has tried modifying her workstation with little success. Additionally, she recently ceased her weight training and cycling workouts, as well as started limiting her social activities due to her incapacitating symptoms. To date, she has not been referred for diagnostic imaging or for a surgical consultation.
Her family doctor has instead recommended CareChain for an advanced neck pain assessment in an effort to get expert answers for her patient, rapid access to spine specialists’ care, and an evidence-based, personalized plan of management.
Assessment
At her CareChain physiotherapist appointment, the patient underwent a comprehensive neck assessment. During her assessment, the CareChain physiotherapist noted that she had no gait disturbances. Her Spurling’s was negative bilaterally and there was no evidence of upper extremity myotomal weakness or dysesthesia.
Accordingly, she was diagnosed with mechanical neck pain (also known as neck dominant pain).
Treatment
The patient was provided with a personalized plan of management, which included an exercise program emphasizing walking and swimming instead of her usual cycling, as well as specific neck exercises and periscapular stability exercises. In addition, the CareChain physiotherapist took the time to educate the patient on the specific aspects of her condition including prognosis, activity limitations, and postural advice.
At the end of the consultation, the CareChain physiotherapist sent a consult note to the referring family physician, which included an outline of the patient’s personalized plan of management, as well as recommendations for ongoing treatment. The patient was advised to touch base with her family physician to discuss non-opioid prescription pain-relieving medications, and to review her plan of management at her earliest convenience. Additionally, she was advised to find a physiotherapist on CareChain, who would be confident in executing her CareChain plan of management.
Over the course of the next eight weeks, the patient attended several physiotherapy sessions. She elected to attend treatment at her CareChain physiotherapist’s office. She was initially seen twice per week, and was instructed to perform her CareChain home exercise program on her days away from the clinic. Each week, her condition was re-evaluated by her treating physiotherapist, and her exercises progressed as per her CareChain plan of management.
Her physiotherapy sessions were reduced as her symptoms improved. Her tolerance for her work duties steadily increased and she slowly started reintroducing her social and recreational activities.
Results
- 80% improvement in her mechanical neck pain
- Neck pain tension improvement with recommended exercises
- Return to cycling and weightlifting activities
- Education on her condition and the importance to stay active
At her 12-week follow-up appointment with her CareChain physiotherapist, the patient reported an 80% improvement in her mechanical neck pain (neck dominant pain), and that her main complaint was primarily related to tension in her neck after prolonged computer work. Nonetheless, the patient indicated that this too was improving with the prescribed exercises and activity recommendations.
Additionally, she reported that overall, she was feeling quite well, and was eager to return to her cycling and weightlifting activities. Physical examination at the time of her follow-up was unremarkable.
The patient was further educated about her condition and the importance of staying active, avoiding aggravating factors until asymptomatic, and the continued importance of managing her condition through neck exercises and periscapular stability exercise.
Conclusion
As is the case with many neck dominant pain patients, this patient’s symptoms resolved through conservative management. Key to this was a comprehensive neck assessment, rapid access to a network of CareChain physiotherapists and an evidenced-based personalized plan of management.
Had her symptoms persisted or worsened, the CareChain physiotherapist would have connected with her family physician to discuss a multidisciplinary approach to managing her symptoms, that would have included changes to her medication, motivational interviewing/CBT, as well as ongoing physiotherapy.
As her symptoms are neck dominant, and there are no neurological deficits, rapid access to a CareChain spine specialist, or advanced imaging, would not be warranted. Nonetheless, her symptoms are now almost resolved, and she has been able to return to most of her recreational activities, without having to wait months or years for an appointment with a spine surgeon.
Looking to relieve your neck pain?
Neck pain is very common nowadays and we understand that it can greatly affect your quality of life. An evaluation and treatment plan offered by a CareChain certified physiotherapist can help you relieve your neck pain. You will be promptly referred to a spine specialist if your physio cannot help you improve your condition. Request a neck pain evaluation by a CareChain physiotherapist today. Or, if you have any questions, or would like book an appointment by phone, reach out to us at CareChain at 1-844-675-2947. Our dedicated staff will be happy to lend a hand, and get you started on your road to recovery today!.