We recently saw a lady presenting with a 6-month history of headache and associated dizziness. She was seen by her GP who advised physiotherapy input.
Having taken a good look at her, she presented with stiffness in the neck and weakness in her neck flexor muscles. She works in an office based job role and plays netball 3 times a week. She has had to stop playing netball.
Further assessment lead us to look at her mid spine, an area often missed when it comes to neck pain.
The mid spine, known as the thoracic spine is a key component in the rotation of the trunk. If there is stiffness or lack of movement here, you tend to get compensation in the neck muscles and joints leading to what’s known as a cervicogenic headache. Her dizziness is caused by muscular tightness in the neck which is secondary to the joint stiffness and tightness.
Physiotherapy management and treatment.
- Hands on manipulation and mobilisations to the lower neck joints and upper mid spine joints.
- Exercise to strength and recondition the muscles of the neck and shoulder blades.
- Exercises to recondition the proprioceptive muscles. These are key to preventing further pain or injury in the future.
We recommended physiotherapy session every 2 weeks to see the benefits of the hands-on work in addition to the exercise therapy.
After 4 sessions, she was able to go back to netball and was pain free.
She returned for a 5th session after 6 weeks for further review. We did some more hands on manipulation to the muscles of the neck and this was enough to discharge her at 100% improvements.