Case History of 77 yrs old male patient

This 77yrs old gentleman presented with complaints of severe neck pain, with tingling and numbness in his left hand, since 6 months
He had initially being treated  2 times for a period of 10 days and 23 days respectively with cervical traction, ultrasound and shortwave diathermy  for his complaints with no relief.
He had consulted with a few orthopaedic surgeons who had prescribed pain killers and further shortwave diathermy and ultrasound. Pain killers failed to relive his pain.

His xray revealed degeneration in cspine.

Clinical Examination- Upon thorough clinical examination of cervical spine and both shoulders..it was revealed that he had very weak rotator cuff muscles and tenderness around his shoulders.His pain on the VA Scale was 8/10 and he was unable to carry out fine motor activities like writing etc.

Treatment- He attended 10 sessions of active therapy at shouldernknee clinics, in vileparle(east), Mumbai.During his sessions the therapist worked exclusively with his scapular and rotator cuff muscles. No heating modalities were used.

Specialised exercises were used to restore the bio mechanics of his shoulder complex. 

Result- 10days post therapy his pain on the VA Scale came down to 2/10. The frequency of pain which was continuous also came down significantly. 

Summary- Even though he was diagnosed of cervical spine issues; the bio mechanics of the shoulder complex along with the cspine are such; that working on his already weak shoulder muscles afforded him almost complete relief from pain. At the end of 15 sessions he was pain free and able to carry out all his activities with ease.

Shoulder and Neck Pain

The neck and shoulder are one of the most used parts of our body, after the brain of course! The neck and shoulder share a lot of muscles that are common to both the joints.  That is these muscles support the neck as well as the shoulder.
The trapezius is one large muscle that attaches on the vertebral column near the neck and the shoulder.The shoulder muscles in comparison are very small and help the shoulder in all its movement. These muscles also get less nutrition when compared to the large trapezius muscle. The trapezius supports the shoulder and the neck whereas the shoulder muscles only support the shoulder.
Due to small size and less nutrition the shoulder muscles tend to weaken before the trapezius. The weakened shoulder muscles stop supporting the shoulder and the trapezius is now overloaded. As aresult after few days the trapezius starts hurting and is wrongly diagnosed as neck pain or cervical spondylosis. This is a common phenomenon, which is followed by a visit to the family doctor/orthopaedic surgeon and intake of painkillers.
The human body adapts to this pain and the pain subsides for some time. This cycle is repeated a few times before the trapezius and other neck muscles just give up and the patient is in tremendous pain.
This is followed by some more painkillers, X-ray and MRI and sometimes surgery for cervical spondylosis.If you have been reading so far, even though you may not be a doctor you know that this is not cervical spondylosis, but incorrectly diagnosed shoulder weakness.
One may argue at this point that the x-ray and MRI show changes and prolapsed disc that indicates cervical spondylosis. Also the patient suffers from tingling numbness in his/her hands and arms. These are secondary changes due to weak muscles at the neck and shoulder.
If the initial shoulder weakness, which was incorrectly diagnosed as cervical spondylosis was treated for shoulder weakness this whole scenario would never had taken place.
Some medical practioners may diagnose the problem correctly and advise SHORT WAVE DIATHERMY, ULTRASOUND OR PULLEY AND SHOULDER WHEEL exercises. These methods prevent excellent short-term relief but never treat the root cause, which is weakness, the heat delivered via short wave diathermy or ultrasound DOES NOT strengthen the muscles.
Pulley and other generic shoulder exercises do more harm than good as straining the shoulder muscles in presence of weakness invariably leads to further damage than good.
The evidence based and right way to manage neck or shoulder pain is to consult a specialist Shoulder surgeon or shoulder therapist. A shoulder surgeon is an orthopedic surgeon who SPECIALIZES in shoulder problems. These are different from a regular Orthopedic surgeon who practices general orthopedics. 

A shoulder therapist could be an Therapist who has specialized in treatment of SHOULDER.

 (In no way is it suggested that a general orthopedic or a general therapist cannot diagnose or treat shoulder problems, but it merely states the fact that a specialist is better versed with these issues.)

Once your problem of neck or shoulder pain has been correctly diagnosed by a battery of clinical tests the treatment plan is chalked out.This typically involves band exercises for shoulder/neck, exercises for movement of the shoulder and neck and a physician referral to evaluate certain vitamin levels.
Note- A True shoulder and neck therapy program rarely involves any heating, painkillers or painful movements. Patients usually report 50% improvement in the 1^st 5-10 days. They are usually pain free by 3^rd or 4^th day.

http://shouldernknee.com/