Neck and shoulder pain from computer usage
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A Case History Prolotherapy Helps Patient with Spinal Cord Compression Mr. K is a 35 year-old office clerk. He has a long history of neck and shoulder pain due to prolonged usage of a computer with a forward-head posture. He injured his neck one day when he was playing with his son in a playground. While supporting his body weight hanging from a play set, he tried to move forward using both hands from one bar to another. He suddenly felt a severe pain in his neck and both hands which caused him to fall down to the ground. He had weakness in all four limbs initially making weight bearing impossible. He gradually regained full walking ability 15 minutes later. His neck pain has continued and he has not been able to make firm grips with both hands since the injury. He went to the emergency room in Hong Kong where X-rays were taken and showed no cervical fractures or dislocation. He was then prescribed physiotherapy in a government hospital and was placed on sick leave for seven weeks. This gave him partial relief of the pain and hand weakness. He was lay-referred to see me eight weeks after the injury. Physical exam showed 4/5 gripping power on both hands, and there was diminished pin prick sensation over the C5-7 dermatome. He was admitted to a private hospital and an MRI found a significant protrusion of the C5-6 disc with compression to the spinal cord. But there was no obvious spinal cord edema from this compression. (See Figures 3 and 4.)
Nerve conduction velocity test showed normal peripheral nerve conduction. I performed the first Prolotherapy under fluoroscopic guidance in early February 2009 with 15% glucose (3cc of 50% dextrose mixed with 7cc of 1% lignocaine (lidocaine)). (See Figure 5.) The injection sites include: Both the superior and inferior nuchal lines, the interspinous ligaments from C2-3 down to T3, the facets joints from C2-3 down to T3-4, the origin of the levator scapulae at the superior and medial border of the scapulae, and the origin of the upper trapezius over the spine of scapulae, and the clavicles. After the first Prolotherapy, there was a 60-70% improvement in his pain and his gripping power increased to 5/5. He could resume his usual activities, including work, one week after the first Prolotherapy treatment
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The second Prolotherapy treatment was initially arranged six weeks after the first in mid March 2009, but since he has nearly full recovery to his gripping power, there is no more pain in the neck and upper limbs, and he has resumed all of his usual activities, thus the second Prolotherapy treatment was cancelled.
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