Hi

I am suprised that joint play was negative in the upper C/S. I trust what you are saying but I just want to ask the question to clarify - C1 rot on C2 was equal in feel and motion bilaterally? And O/C1 and C2/3?

With the stomach pain, viscera has fascial connections as well. But fascia is not the only cause of pain (of course). The sympathetic trunk is located just anteriorly to the Costotransverse joints and if he had a nasty accident (which it sounds like he did) then it may well be linked to altered output.

To tell a short but interesting story... This year I had a patient who could not eat a full meal for two years. He literally would only have about 2 mouthfuls before feeling his stomach cramp up and would have to stop eating. He felt no other pain. Examination showed a stiff T/S and L/S. Pelvis was Ok. Less than 4 treatments had him eating a 3 course dinner on his first date with his new girlfriend. He no longer has trouble. Treatments were mobilisation using MET and manipulation of the L/S and T/S. Visceral pain exists because of physical reasons...

Nightmares just after falling asleep is interesting. I suffer from narcolepsy which has as part of the symptoms sleep paralysis. During these attacks (which i haven't had in ages) I would wake up and hallucinate (be dreaming) but couldn't move. They were very vivid dreams. I also learnt that I dropped into REM sleep very quickly (2.5mins) which is when I would start to dream.

The point of the story is that he may be dropping into REM early or rousing himself during REM. As for the content of the dreams, it sounds psychosocial to me if they have recurring themes.

Sorry about the long post!