Spondylosis Case Study 13.
Mr Thomas, a 67 year old retired Quantity Surveyor, presented to the clinic with a six month history of pain in his neck. This was accompanied with stiffness and restriction. There was no history of any injury or event. His symptoms started gradually becoming more intense 4 weeks before presenting at the clinic. In addition he noticed that he was having difficulty looking over his shoulder. Particularly on staggered junctions or reversing the car. He found that lying down eased his symptoms.
Three months after his symptoms began he went to see his GP. Initially he was prescribed a course of Non-steroidal anti-inflammatory drugs (NSAIDs) which helped to relieve some of his pain. Only after two further visits was he referred for an X-ray. This X-ray confirmed that he had cervical spondylosis from C4-C7 vertebrae. He had been advised that he would be placed on a waiting list for physiotherapy. He decided to seek independent treatment when he learned there would be a 12 to 14 weeks wait for physio.
The findings from the clinical assessment supported the X-ray diagnosis of Cervical Spondylosis. A neurological examination was unremarkable. There was a marked decrease in the global range of motion (ROM) in the neck, particularly side-bending. Mr. Thomas presented with a poor posture, a rounding upper back and a forward head posture. Consequently the musculature immediate to the neck and shoulders were tight and painful to palpation.
Treatment and Management
Initially Mr. Thomas had four treatments over consecutive weeks, gradually showing marked improvement. This treatment involved soft tissue techniques, stretches and gentle mobilizations. He was provided with advice regarding hydrotherapy, exercises and overall management. After the fourth treatment he had considerably less pain. He also demonstrated an improved range of motion in his neck movement. He was keen to build on this improvement and enrolled on a beginners Pilates class which he quite enjoyed. His symptoms were well controlled through a combination of classes and two monthly maintenance treatments at the clinic.
Spondylosis (Spondy means spine; losis means problem)
- The term is often used interchangeably with other terms. Like ‘wear and tear’, ‘arthritis of the spine’ and ‘degeneration of the spine’.
- It affects 85 percent of people over the age of 60.
- Occurs when the soft tissues (muscles, the intervertebral discs, ligaments and cartilage that lines facet joints) naturally deteriorate over time.
- Can occur throughout the spine. The two most common sites for Spondylosis are the neck (Cervical Spine) and the lower back (Lumbar Spine).
- It is relatively uncommon in the thoracic spine because this is connected to and supported by the ribcage.
- Cervical spondylosis — Spondylosis is common in this area, mainly because the vertebrae support the weight of the head and are very mobile.
- Lumbar spondylosis — Spondylosis is prevalent in this region because the lumbar vertebrae supports the majority of the body’s weight.
- Pain or aching over the affected area.
- Stiffness and reduced mobility.
- Muscle weakness.
- Numbness, tingling or loss of sensation.
- Reduce pain and discomfort through a combination of pain relief, NSAID’s, heat treatment, osteopathic treatments and exercises.
- Improve head and shoulder posture. Look at corrective postural exercises and review workstation set up and use of computers/tablets or mobiles.
- Encourage weekly sessions of Stretching / Pilates / Swimming (although show caution with breast stroke).
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Spondylosis Case Study 13.