My first reaction to your question was that we needed more information. My
guess when you write that R sf and R rot relieves is actually a typing error
which would suggest that, using the idea of increasing or decresing the
intervertebral foramen or thoracic outlet, he does not like closing down and
this could be due to a number of factors eg mild nerve root compression,
thoracic outlet syndrome, stenosis.
My initial questions were.
1. What is his history, is it insidious onset or acute in origin
2. What is is job and what past times does he enjoy
3. Resting posture ?? including night positions and symptoms
4. Are his movements symmetrical
5. Does he have any neuro signs, if not have you cleared these any way
6. What is the effect of combined movements, especially in provocative
7. Does offloading the shoulder girdle in provocative position change his
symptoms at all
8. What are your passive movements like and are there any significant
Look forward to hearing more
----- Original Message -----
From: "nabil keshavjee" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, October 12, 2001 2:51 AM
Subject: Neck pain with referral.
> I'm kinda stuck with one of my patients. Any help
> would be greatly appreciated.
> Subjectively, main complaint is radiating pain down
> to left hand. Mainly happens when he gets into his
> car. Eases as the drive continues. Also occurs
> sporadically during the day.
> Objectively(I'll keep it short), right sideflexion and
> right rotation relieve. Flex, ext, R sf, and R rot,
> increase the pain. Traction in neutral increases
> pain, traction in 20 degrees flexion decreases.
> Negative Adsons.
> Let me know if you need to know more. Getting late so
> I'm half brain dead.
> Nabil K,
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