Adrian presented for physiotherapy on the 8th June, 2010 and was interested in the Chronic, Complex and Repetitive Pain Therapy services on offer at Lifestyle Therapies.

Background
Adrian had complaints of upper back pain that he had suffered for more than 14 years. His symptoms had progressively worsened in the previous four years and recently became unbearable. He also had a history of a frozen shoulder that occurred 12 months ago. Adrian was emotionally frustrated having to deal with the pain for so long with minimal relief after seeing several different therapists, including an acupuncturist, physiotherapist, multiple chiropractors, rheumatologist and musculoskeletal doctor.

On Assessment
On assessment, the findings included:
• Muscle tightness especially in the Upper Trapezius, Rhomboids, Posterior Scalene muscles.
• Tender on palpation in the upper thoracic region with hyperactive trigger points.
• Poor posture
• and weak shoulder stabilisers.

It was determined that Adrian’s chronic pain had caused inhibition to muscle activation and increased muscle tightness which resulted in weakness and poor posture. Adrian’s goal for treatment were to decrease the symptoms frequency and to return to doing specific exercises and stretches that he has not be able to do in a long time.

Treatment
In order to achieve these goals, treatment commenced with a combination of different modalities with the aim of eliminating the pain and end the cycle of muscle inhibition and tightness. Firstly, Low Level Laser Therapy was used to reduce musculoskeletal pain, promote tissue repair and target stubborn trigger points. Secondly, Neuromagnetic Therapy (Q magnets) to interrupt the nerve pain pathway. These were placed on the spine at T1, T2 and C7 centrally to affect the dorsal column and branches to the sympathetic system and one over the trigger point of the trapezius.

Outcome
After a couple of sessions, there was a significant decrease in muscle tightness and pain which then allowed us to work on posture and reconditioning Adrian’s muscles. We gave Adrian a prescribed home exercise program that was specific to strengthening shoulder stability and re-training posture. Other treatments included, mobilisation, soft tissue releasing techniques and using TENS.

It has now been two months since Adrian first presented to Lifestyle Therapies. He has reached his goals being close to pain-free, the frequency of symptoms has dropped significantly and he is getting back into doing the things he loves. Adrian only needed to hire Q magnets for a period of two weeks after which his pain did not return.

Vanessa Chung Martinez; Lifestyle Physiotherapist™