thanx gcoe for ur prompt response
u mentioned some points
like trigger point....since the pt is getting symptoms in palm and also there is radiation component present ,i doubt it could be becoz of trigger point??
2)u mentioned to check with dermatome!!!clinically and subjectively pt has c5,c6,c7 and c8 dermatome involvement mainly parasthetias.
3)inflammatory component!!
had it been inflammtory it could have been more irritable????? but for me it seems moderately irritable (between irritable and non irritable)...as pt has been doing neuro tissue mobi successfully.....without provoking with progression of stretches
my queries over ur comment---
as i have mentioned in previous note pt has severe degenerative changes in cx spine x ray so how much we can go with cx mobi?
secondly,i mentioned in the previous note,pt gets tigling with neck isometric contractions??i tried with towel exr....when i tried with pressure feed back with mild contractions so symptoms but with vigorous contractions she gets the same???? so i m a litle confused about the region of involvement i mean primary....whether upper cx is primary or lower cx ?????

ur take on this

thanx