Neck pain 1: Myofascial

Presenting symptoms

A 29 year-old female office worker reported recurring neck pain that alternated between right and left sides. The pain came intermittently every few months and would sometimes last a few days, or at other times, for weeks. She reported a lot of stress at work, poor telephone technique and faulty desk ergonomics.

Evaluation, clinical reasoning & treatment strategizing

Range of motion assessment showed significantly reduced neck rotation (right) accompanied by pain on the same side. Palpation revealed a short and tender SCM (sternocleidomastoid muscle) producing pain when turning the head to the right.  In addition, the right posterior neck muscles (right rectus capitis posterior minor and right levator scapulae) had active myofacial trigger points imbedded.

Treatment

Neuromuscular techniques were utilized to restore proper muscle length and balance of anterior and posterior neck muscles (right upper trapezius, sternocleidomastoid, right levator scapula, bilateral semispinalis capitus/cervicis, splenius capitus/cervicis, and the sub-occipitals).  Moist heat application was suggested for the treated area. This helped with circulation and prevention of trigger point recurrence.

Outcomes & follow-up

After the first treatment, pain-free full range of motion was restored. Homecare activities for posture were given to prevent the return of symptoms. Proper ergonomics were discussed for the patient’s workstation and a hands-free headset installed.  She returns to Myopain Solutions on an as-needed basis.