ESSENTIAL ASPECTS OF PHYSIOTHERAPY IN THE SUCCESSFUL TREATMENT OF A PATIENT WITH CERVICAL DISC HERNIATION: A CASE REPORT
DOI:
https://doi.org/10.15621/ijphy/2020/v7i2/657Keywords:
Mckenzie approach, neck pain, disc prolapse, deep cervical flexors strengthening.Abstract
Background: Cervical disc herniation is one of the major conditions resulting in neck pain, which in turn affects the patient's activities of daily living. The Conservative approach is always being challenging among these patients due to the feeling of insecurity and the related severity of symptoms. McKenzie's approach has been used worldwide for slipped disc issues in providing relief by reducing the disc pressure and radiating symptoms. Deep Cervical Flexors strengthening plays a vital role in providing neck stability and thereby improving the posture.
Case Summary: A case of neck pain with radiation into the left upper extremity going down to the left hand in a
47-year-old female was presented to physical therapy and has been referred by an orthopedic surgeon with a diagnosis of acute cervical disc prolapse at the C5-6 level. After the initial evaluation, muscle energy techniques were initially given to increase the ROM of the cervical spine as the neck was stiff. Mckenzie techniques were executed, including manual traction for 15 days along with basic ROM, neck isometrics, and DCF strengthening.
Outcome measures: Numeric Pain Rating Scale (NPRS), Cervical ROM, Neck Disability Index (NDI), Tampa Scale for Kinesiophobia (TSK) were used.
Conclusion: Mckenzie protocols combined with Muscle Energy Techniques (MET) and DCF strengthening exercises revealed that there was a significant improvement in the patient's functional ADL with a marked reduction in disc herniation and its associated symptoms.
References
Côté, Pierre DC., Cassidy, J. David DC. & Carroll Linda. The Saskatchewan Health and Back Pain Survey: The Prevalence of Neck Pain and Related Disability in Saskatchewan Adults. Spine. 1998; 23(15), 1689-1698.
Bongers, P.M., Ijmker, S. & Van Den Heuvel, S. Epidemiology of work related neck and upper limb problems: psychosocial and personal risk factors (part I) and effective interventions from a bio behavioral perspective (part II). J Occup Rehabil. 2006; 16(3): 279–302.
Callaghan, J.P. and McGill, S.M. Intervertebral disc herniation: studies on a porcine model exposed to highly repetitive flexion/extension motion with Compressive force. Clin. Biomech (Bristol., Avon). 2001; 16(1):28–37.
Costi, J.J., Hearn, T.C. and Fazzalari, N.L. The effect of hydration on the stiffness of intervertebral discs in an ovine model. Clinic. Biomech.(Bristol., Avon).2002; 17(6): 446-55.
Pospiech, J., Stolke, D., Wilke, H.J. and Claes, L.E. Intradiscal pressure recordings in the cervical spine. Neurosurgery discussion. 1999; 384–5, 44(2):379–84.
Hoff JT, Papadopoulos SM. Cervical disc disease and cervical spondylosis. In:Wilkins RH, Rengachary SS, editors. Neurosurgery, New York:McGraw-Hill. 2nd ed; 1985.
Constantoyannis, C., Konstantinou, D., Kourtopoulos, H. and Papadakis, N.Intermittent cervical traction for cervical radiculopathy caused by large-volume herniated disks. J. Manipulative Physiol. Ther. 2002; 25(3):188–92.
McKenzie RA. The cervical and thoracic spine. Mechanical diagnosis and therapy. Waikanae. Newzealand: Spinal Publications; 1990.
Goodridge JP. Muscle energy technique: definition, explanation, methods of procedures. J Am Osteopathic Assoc. 1981; 81(4): 249-54.
Gary Jacob. Rehabilitation of the spine, A Practitioners manual. Chapter 15, McKenzie spinal Rehabilitation Methods. 345
Fennell AJ, Jones AP, Hukins DW. Migration of the nucleus pulposus within the intervertebral disc during flexion and extension of the spine. Spine. 1996; 21 (23):2753-57.
Ordway RN, Seymour RJ, Donelson RG, Hojnowski LS, Edwards WT. Cervical Flexion, Extension, Protrusion and Retraction. A radiographic segmental analysis. Spine. 1999; 24(3):240-47.
Deborah L.Falla, Gwendolen A.Jull & Paul W. Hodges. Patients with neck pain demonstrate reduced electromyographic activityof the deep cervical flexor muscles during performance of the craniocervical flexion test. Spine. 2004; 29(19):2018-2114.
Deborah Falla, Shaun O Leary, Amy Fagan & Gwendolen Julla. Recruitment of the deepcervical flexor muscles duringa postural-correction exercise performed in sitting. Manual Therapy. 2007; 12(2): 139-143.
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