Objective: The purpose of this case study is to discuss a positive outcome of conservative therapy on a patient with idiopathic, multi-level radiating neck pain.
Clinical Features: A 52-year-old male presented to an outpatient chiropractic clinic with severe radiating neck pain for ten days with unknown mechanism of injury. Patient states he is experiencing numbness and tingling in the left arm into the thumb and index finger as well as decreased and painful cervical spine range of motion. Affected activities of daily living include cooking, sleeping, eating, driving, and working overhead. Cervical spine radiographs and cervical spine MRI were performed revealing multi-level disc herniations with degeneration as well as left lateral recess stenosis and a stenotic left neural foramen at the level of C5/C6.
Intervention and Outcome: Treatment included cervical flexion/distraction, class IV cold laser, therapeutic ultrasound, axial decompression, shockwave, active rehabilitation, and thoracic spinal adjustments. After 6 months of treatment, the patient's VAS score decreasedfrom a 9/10 to a 2/10. Patient had visualized increased range of motion and no longer had any affected activities of daily living.
Conclusion: In this case report, a patient benefited from a multimodal approach to conservative care. This suggests that combination therapy can be effective for patients with multi-level disc herniations and associated radiculopathy. The result of decreased VAS, visualized increase in range of motion, along with improvement in activities of daily living demonstrate important functional improvement in this patient. Further study should be done on combinations of the chosen modalities to evaluate their combined effectiveness.
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