Document Type

Case Report

Department

Physical Therapy & Rehabilitation Science

Degree Name

DPT (Doctor of Physical Therapy)

Session and Year of Graduation

Fall 2017

Advisor

Laura Frey Law

Abstract

Background: Chronic neck pain and functional disability is a common occurrence following whiplash injuries and frequently results in sensory, motor, and psychological dysfunction. Individuals presenting with chronic pain may exhibit widespread hypersensitivity, post-traumatic stress reactions, and emotional distress. Therapeutic neuroscience education (TNE) is a physical therapy intervention aiming to assist with pain, suffering, and disability by helping patients understand pain from a biological and physiological perspective. Case Description: The patient was a 42-year-old female presenting with left-sided neck pain with radiating symptoms throughout her left shoulder and spine following a motor vehicle accident. Evaluation at 7 months post-injury revealed intolerable pain throughout the cervical and thoracic spine, cervical mobility impairments, and a history of migraines, depression, and anxiety. This case report illustrates the rehabilitation approach used to enable effective execution of functional tasks in an unrestricted manner. Intervention: Rehabilitation progressed for 12 visits (6 weeks) including TNE, manual therapy, and therapeutic exercises. TNE was implemented to educate regarding nociceptive inputs, the sensory cortex, pain perception, central sensitization, and the brain neuromatrix. Outcome Measures: The patient demonstrated a Functional Measure of 31/100 and Physical Fear Score of 19/100 on the Focus On Therapeutic Outcomes (FOTO) Assessment during the initial evaluation. Following 6-weeks of physical therapy rehabilitation, the patient demonstrated a Functional Measure of 88/100 and Physical Fear Score of 80/100. Discussion: The purpose of this case report is to discuss the clinical reasoning and rehabilitation approach for an individual with chronic pain. This case report supports the use of TNE, manual therapy, and therapeutic exercise for chronic disorders in reducing pain, improving knowledge of pain, and reducing disability and psychosocial factors relating to pain.

Keywords

Orthopedics - Upper Extremity

Pages

10 pages

Copyright

Copyright © 2017 Joel Ingram

COinS
 

URL

http://ir.uiowa.edu/pt_casereports/13