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i have a patient who is women 57, who has had a gradual onset of pain over last 4 weeks, last week she started experince pain over right deltoid area, down the arm as far as the elbow, there is no numbness or parasthesia, aggravating factors are sitting and turning head right, she is taking iburpfen.she has had occasional neck pain in the past but no previous physio
help me please? im not sure what to do with this patient
have you tried searching trigger points in neck? Probably the syntoms are caused by refered pain. Try it, treat them (if there were) and write me back please.
Hope I've helped you
trigger points is a living myth of physiotherapy...A fashioned theory once started by Travell and Simmons but now is being discarded...For more evidence search in PubMed about the work from Quintner...He had published many articles on this subject and what we like to say as "trigger point" is just a form of "SECONDARY HYPERALGESIA" caused by either peripheral or central nervous system mechanisms....Not to mention that even in ASYMPTOMATIC subjects if u use pressure on specific areas u will find out "trigger points"...SO???
Neck movement aggravates symptoms? Assess the neck! Look at all the usual stuff, posture, physiological movements, accessory movements, muscle length and strength. Treat what you find.