An Outpatient Physical Therapy Intervention Program

BACKGROUND AND PURPOSE: Two thirds of the United States population may experience neck pain at one point in their life. Two common categories of neck pain are whiplash associated disorders (WAD) and cervical radiculopathy. Conservative non-operative management of cervical radiculopathy is effective with the majority of patients. The purpose of this case report is to describe the outpatient physical therapy intervention for a patient with cervical radiculopathy. CASE DECSRIPTION: The patient is a 47- year-old right hand dominant female with a complicated history of neck pain referred to physical therapy for evaluation and treatment of cervical radiculopathy. Symptoms included bilateral cervical and upper thoracic pain, and upper extremity radicular symptoms. Decreased cervical and upper extremity range of motion (ROM), upper extremity and scapular muscle weakness, and significant tenderness with palpation were found. Eight visits over a six week course of therapy focused on nerve glides, soft tissue mobilization, joint mobilization and manipulation, therapeutic exercises, and a trial of cervical mechanical traction to reduce pain and increase function. OUTCOMES: The patient reported decreased overall pain, and improved cervical ROM and self management skills. Shoulder ROM, upper extremity and scapular strength did not improve. Tolerance to work and exercise activity did improve since the start of treatment. Neck Disability Index scores increased from 14/50 to 19/50, indicating greater functional difficulty. DISCUSSION: The interventions detailed throughout this report are supported by varying levels of research and may be related to changes in this patient’s impairments and function. Any lack of improvements or gains made by the patient could iii also be related to her motivationand activities she participated in outside of her therapy visits. Few studies are available to represent cases in which conservative treatment for cervical radiculopathy is unsuccessful and who potentially may require surgical referral. This case report helps to give current insight into one such possible rehabilitation experience