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[ Chapter 14 ]
❖ Case 1
• 35-year-old computer programmer
• Pain symptoms in the right cervical, posterior shoulder, and arm regions
• The symptoms get progressively worse when at work; usually the pain begins within 1 hour, and it is 6/10 by lunchtime.
• There is occasional tingling in the thumb and index finger.
• The symptoms have progressively worsened over the last 3 months, ever since being placed in a priority job.
• Recreational activities include tennis and reading; the tennis does not cause symptoms, but reading makes the neck pain worse
• Examination reveals forward head and round shoulder posture.
• Capital flexion 50% range, cervical rotation and side bending are each 80% range, shoulder external rotation is 75°.
• There is restricted flexibility in the pectoralis major, pectoralis minor, levator scapulae, and scalene muscles.
• Cervical quadrant test reproduces the tingling in the right hand; all other neurological tests are negative.
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