Mrs Z a full time secondary teacher presented with a 3 week history of severe left shoulder and neck pain and chronic debilitating headaches. She had put up with her pain but it was beginning to disturb her sleep and work performance.
Mrs Z was quite stressed by her ongoing levels of pain and wanted to alleviate the headaches, regain pain free neck movement, to reach forward and overhead pain free with the left arm and to tolerate using the laptop for 30 minutes with no pain increase.
On examination, neck movement was painfully restricted as was forward or overhead reaching with the left arm. Adverse neural tension signs were evident when testing the left upper limb and both lower limbs. Trigger points and muscle tension were palpated throughout the neck and posterior shoulder region particular upper trapezius, levator scapulae and the rotator cuff muscles bilaterally. Palpation of the right psoas muscle deep in the anterior aspect of the abdomen was also exquisitely tight and tender.
Through a process of objective testing to confirm the best approach to treatment, Mrs Z responded to releasing of the tight psoas muscle. Mrs Z had a self reported improvement of 80% on a pain/dysfunction scale after 3 treatments. Releasing the right psoas muscle improved active movement in the neck and decreased the levels of shoulder pain and headache significantly. As an interesting side note, release of the right psoas muscle also improved the trigger points in the neck and posterior shoulder region which was quite remote from the site of treatment.
This demonstrates that based on objective testing criteria and thorough neural release work improvements can be made in areas quite remote from the pain presentation.
