Type of Article : Case Report
Year: 2015 | Volume 3 | Issue 6 | Page No. 1312-1317
Date of Publication: 11-12-2015
MULTIMODAL PHYSIOTHERAPEUTIC APPROACH IN TREATING A PATIENT WITH ACUTE CERVICAL DISC PROLAPSE: A CASE REPORT
Department of Physiotherapy, Medeor 24x7 Hospital, Abu Dhabi.
Corresponding author: Rathish Manickam, PT., Department of Physiotherapy, Medeor 24x7 Hospital - A Unit of VPS Health Care, PO Box 40330, Abu Dhabi - United Arab Emirates. Tel: +971 26900 600.
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Background and Purpose: Cervical disc prolapse is one of the leading cause of morbidity and affecting the patients routine work of their ADL. Due to severity of symptoms and patients feeling of insecurity, physiotherapeutic conservative approach is questionable and has become challengeable against surgery. The purpose of this case report is to explore the efficacy of multimodal physiotherapeutic approach in treating a patient with acute cervical disc prolapse.
Case Description: 33 year old male patient was diagnosed with acute cervical disc prolapse and the pain was radiating to the right upper limb associated with numbness. The patient was given initially physiotherapeutic modalities like cryotherapy, ultrasound and mechanical traction to reduce pain. Muscle Energy Technique was also implemented for initial days along with cryotherapy based on cryokinetics concept to enhance movements of cervical spine. Mckenzie exercises with appropriate techniques was administered for 10 days along with retraction exercise, basic ROM and neck isometrics as a home program. The patient received treatment for a period of 12 days.
Outcome Measures: The outcome measures used were Numeric Pain Rating Scale, Neck Disability Index, Tampa Scale for Kinesiophobia, and Cervical ROM.
Conclusion: Multimodal physiotherapeutic approach along with Mckenzie technique played a significant role in alleviating pain, numbness and improvement of the patient functionally for return to his normal work.
KEY WORDS: Cervical disc prolapse, Physiotherapeutic modalities, Mckenzie approach,Neck Disability Index, Numerical Pain Rating Scale, Tampa Scale for Kinesiophobia, Cervical ROM.
- Cote, Pierre DC., Cassidy, J. David DC. & Carroll Linda. The Saskatchewan Health and Back Pain Survey: The Prevalence of Neck Pain and Related Disability in Saskatchewan Adults. Spine. 1998;23(15):1689-1698.
- Dorshimer, G.W. & Kelly, M. Cervical pain in the athlete: common conditions and treatment. Prim Care. 2005;32:231–243.
- Bongers, P.M., Ijmker, S. & Van Den Heuvel, S. (). Epidemiology of work related neck and upper limb problems: psychosocial and personal risk factors (part I) and effective interventions from a bio behavioral perspective (part II). Journal of Occupational Rehabilitation. 2006;279–302.
- Callaghan, J.P. and McGill, S.M.. Intervertebral disc herniation: studies on a porcine model exposed to highly repetitive ﬂexion/extension motion with Compressive force. Clin. Biomech. (Bristol., Avon), 2001;16(1):28–37.
- Chicago Institute of Neurosurgery and Neuroresearch website
- Pospiech, J., Stolke, D., Wilke, H.J. and Claes, L.E. Intradiscal pressure recordings in the cervical spine. Neurosurgery discussion. 1999;44(2):379–85.
- Hoff, J.T. Cervical disc disease and cervical spondylosis.In:Wilkins, R.H., Rengachary, S.S., editors. Neurosurgery New York:McGraw-Hill. 1985.
- Constantoyannis, C., Konstantinou, D., Kourtopoulos, H. and Papadakis, N. Intermittent cervical traction for cervical radiculopathy caused by large-volume herniated disks. J. Manipulative Physiol. Ther. 2002;25(3):188–92.
- McKenzie R. The cervical and thoracic spine. Mechanical diagnosis and therapy. Waikanae: Spinal Publications (N.Z.);1990.
- Gorel Kjelman & Birgitta Oberg. A randomized clinical trial comparing general exercise, mckenzie treatment and a control group in patients with neck pain. J Rehabil Med. 2002;34:183–190.
- Basantha Kumar Nandha. Electrotherapy Simplified.1st Edition : 2008, 400-401
- Starkey Chad. Therapeutic modalities. 3rd Edition: 2004, 113
- Goodridge JP. Muscle energy technique: definition, explanation, methods of procedures. Journal of American Osteopathic Association. 1991;81:249-254.
- Gary Jacob. Rehabilitation of the spine. A Practitioners manual. McKenzie Spinal Rehabilitation Methods. (Chap.15) Lippincott Williams & Wilkins. 345
- Fennell AJ, Jones AP, Hukins DW. Migration of the nucleus pulposus within the intervertebral disc during flexion and extension of the spine. Spine. 1996;21 (23):2753-2757.
Rathish Manickam. MULTIMODAL PHYSIOTHERAPEUTIC APPROACH IN TREATING A PATIENT WITH ACUTE CERVICAL DISC PROLAPSE: A CASE REPORT. Int J Physiother Res 2015;3(6):1312-1317. DOI: 10.16965/ijpr.2015.197