Week 3

S: 68 year old female presenting with neck pain. She has had a history of recurring episodes of neck pain throughout her life but have been self resolving. She has not required any management until this most recent episode lasting 4 months. She has no relevant past medical history or any medical conditions. The neck pain has been affecting her range of motion looking behind her right shoulder while checking her blind spot, looking up, and she is unable to roll over in bed without sitting upright first. She described her neck pain as a constant ache varying between a 3-4/10 pain.

T: perform a full subjective, objective, and appropriate treatment.

A: I took the relevant subjective history and completed a full objective assessment. I was able to establish that C3/4 was the level producing her pain and was limited into extension and right rotation. I then performed a passive accessory technique to improve right rotation and extension.

R: On reassessment of her active range of motion, there was a significant improvement in the range into right sided rotation. The treatment did not have much effect on pain which was to be expected as the technique was into the provocative direction.

E: I think I chose the appropriate treatment technique although provocative to use for this patient. I was able to find the level reproducing the pain and restricting the range of movement. I do think that my assessment technique for motion palpation needs improvement as I am unsure at times how to assess what I am palpating.

S: I asked my supervisor to perform a motion palpation on the patient as well and then discussed with him before I continued on to a treatment. This way, I was able to compare the findings and see if my assessment was accurate. I also discussed the most appropriate technique before choosing it. I found it easier to brainstorm ideas with my supervisor first and then perform them.