cervical pain

[fisiosimo]

sorry...How can a disk prolapse if at age of 60 the nucleus does not exist anymore ? Please let me know...

[physiobob]

It is unusual that a 60 year old would have a "fresh" disc lesion as you are correct in assuming quite a bit of dessication would have already occured. This does not stop the actual disc itself from becoming painful. The scapular tenderness might well indicate the upper C4 region as a possible cause of the current issue. Remember most of us would have these disc lesions if MRI'd.

I agree with the simple comment that careful examinationis required to try to implicate the focal point of the problem. In an osteoporotic client the "good news" is that the joints should stabilise and partially fuse overtime and this should burn out. This could however lead to excess bone growth and narrowing of the exit foramen. Perhaps treat this as an inflammatory condition as a first step while you investigate further. You investigation is likely to aggravate the symptoms so following it up with something to minimise the irritation would be nice.

Long term considerations would be to look at the amount of thoracic kyphosis and maintainance of the upper lumbar lordosis. With this type of client you need to be gentle and progressive and need to educate them as to the importance of maintain at lease what posture they still have to prevent futher compression of the mid cervical spine as a result of increased thoracic kyphosis.

DO mose more careful examination and tell us what you find