| خلاصه مقاله | introduction: The patient was a 45-year-old female who works continuously with computer. On November 24, 2017, she referred to the Imam Khomeini Physiotherapy Clinic of the Rehabilitation Faculty. The MRI and radiography showed no evidence of discopathy, osteoarthritis, etc. The patient has been suffering from neck pain for the past six months with referral pain to the left upper limb, which has intensified in the last one month. Placing the hand on the back of the head significantly reduced the symptoms in the neck and upper limbs (Bakdi's sign) and as a result the person had to maintain this position for many daily tasks such as driving and working with the computer.
Methods: The treatment was performed in 15 sessions in the form of a combination of electrotherapy, manual therapies and exercise therapy. In the first 5 sessions, routine neck pain treatment was performed to reduce pain, but the patient did not report significant improvement. The severity of the patient's pain prevented the patient from being properly positioned to perform the desired techniques. From the sixth session, a new approach was considered along with routine treatment. This treatment, based on previous studies, is a combination of positional release and myofacial release of the axial muscles of the scapula and neck.
If the patient has pain on the left side, the technique is performed as follows: First, the most comfortable position is selected, while the patient lies on the left side of the body and the left hand is on the right shoulder and the right hand is on the bed. The therapist is placed on top of the patient's head and applies a force with the least pain, perpendicular to the bed, to the inner edge of the scapula and again in a downward direction to the upper edge of the scapula. The applied force is maintained for 90 seconds.
Results: At the end of the sessions, the pain scale decreased from 7.4 to 1.3 and the cervical disability index from 70% to 4%. Follow-up of the patient one year after treatment indicated complete relief of pain and disability and return to normal life. It seems that this treatment, which is a combination of two important physiotherapy techniques, can be effective in disorders of the axial muscles of the scapula and neck, which are very common. |