Sreenivasa Rao
Physiotherapy
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am suffering from severe pain in my cervicothoracic spine and upper right back and scapula and right shoulder and right arm accompanied by numbness in the right forearm for the last 40 days. The pain is acute during bending, sitting, and walking but I get some relief while lying down on the bed on my back. I got my MRI done in which it has been revealed that there is a diffuse annular bulge with posterior right lateral disc extrusion at D1-D2 level which is causing severe compression over the right lateral recess with entrapment of the exiting nerve root. I have tried McKenzie neck exercises but my right upper back and cervicothoracic pain has only increased. Please advise how can I get relief from acute pain. Please suggest treatment to get relief from acute pain in the cervicothoracic spine region, upper right side back, scapula area, and right shoulder and arm. I tried McKenzie's neck exercises but my pain has only increased.
Hello,
Welcome to icliniq.com.
I read your concern. I would like to know the exercises McKenzie correction you had done for reduction. You need a proper manual therapy assessment and mechanical restoration with mobilization. I would like to advise you to get your D1 properly mobilized with a physiotherapist. The mobilization of the facer joint will also help you a lot. In your case, McKenzie should work better as I do not know what have you done. And what kind of mechanical restoration was done and manipulation performed? Kindly give me details so that we can suggest your correction.
Manipulative correction of deranged spinal alignment will help you to recover faster. Keep icing your upper back and lower part of the neck. Avoid prolong bending forward movement. Try massaging over upper neck and scapula gently to reduce spasm. And thereby reducing the pain. Try lying down in that position that gives you maximum comfort. Kindly revert back so that I can help you to choose better techniques and speedy recovery.
The Probable causes
Treatment plan
Preventive measures
Patient's Query
Thank you doctor,
As part of McKenzie's exercises, I did chin tucks, back movement of the head, side movement of the head, and touching the shoulder with the ear on either side. This aggravated my pain in the cervicothoracic and scapular region.
Hi,
Welcome back to icliniq.com.
I recommend you to do the following exercises. Lie on your stomach with elbow support so that your both hand is supporting the base of your jaw. Your entire neck should be arched and you should be feeling the stiffness in the cervicothoracic area. Stay in this position for 15 minutes if you can tolerate then go up to 20 minutes. This exercise has to be done 4 to 5 times a day. Do not do those exercises you did before. Get a theraband and do exercises like placing the theraband behind the neck while both ends and hold in both hands slowly. Do neck extensions like pushing your neck back against theraband resistance. Turn your neck to forty-five degrees like midway between the nose line and the shoulder line. Do the same neck extensions. A lot of icing has to be done. Maintain neck posture with a rolled towel placed below the neck. Do not bend forward too much, normal activities are allowed. But you have to operate your mobile phones and desktop or laptop at your eye level. Do some thoracic mobilization exercises with a foam roller or with an iced 2-liter water bottle. Please do let me know after 2 days.
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Physiotherapy
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