Friday, May 17, 2019

Not The Neck, Not The Leg, But The Arms

This patient who came in recently this week complaining of neck pain, was a really interesting case.

She had pain in the cervical spine (neck) area with numbness and tingling sensations radiating down to her right arm and thumb. Sleeping on her right side made the pain worse.

Remember I had written about my patient with neck pain and I made her better by treating her leg. Well, this particular patient's presentation was definitely different.

This patient of mine lives on a yacht in the One 15 Marina Sentosa Cove. Recently it's been raining and she's had to work a lot harder cleaning her yacht so there won't be stains. Because of the proximity of the refinery nearby, whenever it rains it makes their yacht very dirty. Her husband cleans the hull, and she needs to polish the silicone joints.

She had also seen the spine surgeon and he sent her for an MRI just to be sure. Here's the whatsapp message I received from the doctor telling me my patient had R spinal exit stenosis from prolapsed discs in her neck.

That was a big clue for me as her neck didn't didn't seem particularly "bad" upon palpation. Her upper limb tension tests elicited some tenderness as well.

Superficial and deep front, back arm lines
So I treated her arm lines instead of treating her neck. Yes, at no point did I treat her neck, just her arms and nothing else.

When she sat up, her first comment was "it's like a whole weight have been lifted off my shoulders".

Surprised? I was, but I was hoping for a good result since she told me about all the extra cleaning she did earlier. Treating her arms was key in her case, not her neck.

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