Objective ROM’s evaluation and pain improvement after vertebral manipulation of the cervical spine

Author: Doctor Stefano Bigagli

Anamnesis:

29-year-old woman. She works as a secretary in a notary’s office, she spends about 8 hours a day in a sitting position in front of the PC which is in a position that forces her to a kyphotic position of the dorsal tract of the rachis. For over a year he has suffered from neck pain and almost continuous occipito-parietal headache, with varying degrees of intensity; sporadically also nausea and dizziness. Symptoms generally worsen in the afternoon/evening. The oral NSAIDs, advised by the doctor, bring only momentary relief.

The physiotherapeutic evaluation shows a decrease at the pressure pain threshold with painfulness in the middle and upper cervical paravertebral area, upper trapezius, and bilateral sternocleidomastoid; it also presents a slightly painful functional limitation in flexion and right inclination.

Test with Baiobit:

Cervical ROM test before and after bilateral HVLA manipulation of the upper cervical spine (15-day follow-up).

Rehabilitation program:

The patient performed, as prescribed, frequent movements of the neck in rotation and extension of the dorsal spine, from sitting, during the day while she was at work.

Results:

At the second session, carried out 15 days after the first, after a session of vertebral manipulations and daily sessions of mobilization exercises of the cervico-dorsal spine lasting about 30 “every half hour, performed during one’s work, the patient no longer complains of headache and dizziness or neck pain. There remains a sensation of muscular “tension” at the base of the neck. The patient, recognizing the benefits of exercise, enrolled in a Pilates course.

The movement test with Baiobit objective a clear improvement (quantifiable in about 25%) of the ROM in the limited directions.

HVLA Manipulation 

Cervical ROM – First Session

Cervical ROM – Second Session

ROM comparison DX and SX rotation

ROM Flexion-Extension Comparison

Lateral ROM Bending Comparison

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