Hi I’m Marci, Dr. Stein and I’m an occupational therapist and in 2007 I had symptoms that
were mimicking multiple sclerosis but come to find out I had a bulging disk at C5-6 that
was bulging to my spinal cord so I had symptoms all the way down my body.
So I had surgery for that, a subsequent surgery at C4-5 the next year and since that time
I’ve had just chronic pain in my neck, loss of range of motion, pain that goes up the
back of my neck into my head.
And I just haven’t been able to find anything relieved.
How many years now with this pain?
So the last surgery was 2009, so the last like 7 years.
So 7, the last 7 years.
How much pain from 0-10 at worse?
At certain times its been debilitating at certain times so maybe a 7 would be the highest,
but on a daily basis it’s like a 2 to 3.
2 to 3?
Thats a constant pain Pretty constant pain yeah
And you were mentioning stuff about your headache can you talk about this.
Yeah I get the pain that goes up the back of my head and it doesn’t really come in
here unless it is a seasonal allergy.
But I feel like on my neck if I sleep on a pillow that’s too high or in my work if
I’m doing a lot of neck flexion like bending down over I work with kids.
I just get this pain that goes up the back of my head and then just you know I really
feel like I’ve really lost range of motion when I go this way especially shooting pain
coming into this area so that’s the pain.
1:57 Any other symptoms?
Once in awhile my arms will be aching and I know that’s from my neck because prior
to my second surgery that’s how I knew my neck another disk had bulged.
I just thought I had broken my thumb it was so achy down here so as soon I get the achy
feeling in my hands then I know it’s from my neck.
You don’t have aching now?
Now I don’t, right now I don’t So can you tell me what type of treatment
you had before?
I’ve had some physical therapy that was more just trying to release the mhm.
Manually with the hands.
Yes, yes and some you know manipulation for movement range of motion, which I felt like
it helped some during that time, but I never after those surgeries really got back to where
it was pain free.
Okay, alright and did you have any other treatment other than PT physical therapy.
No Okay, alright so everything we do should not
aggravate your symptom.
Okay So first we are gonna just visually take your
range of motion extend and flex and see how far
Okay And you let me know where is the tightness
when you do that I mean theres some tightness at the very end
range of motion So in the occipital area?
Yes Okay flex
That’s tight This it’s super tight down the right side
and just feels like a rubber band is getting pulled and I’ve been trying to stretch you
know by holding this.
So rotate left and right Again that starts pain down into my trapezoid
So the range of motion restriction is extension and flexion, okay so let me work with you
and make sure it does not aggravate your symptoms.
Okay So both surgery were anterior?
Yes So feel this tightness this is fascia tightness.
It should move like this Oh wow okay
So I’m going to release it with I call it A1
Okay ASTR instrument.
Any discomfort with that?
No How does this feel now?
Can you tell, can you feel the mobility?
Should I flex my, oh I can feel it this way a little bit.
It just feels tight going this way.
Let’s just scoot forward a little bit.
Is it okay to work here?
Yes 5:00
Have you ever had back issue?
No, not.
I mean not chronic.
The other day I was holding my niece for a long time and my lower back was hurting a
little bit.
I feel the tightness.
But I know I mean all this is connected right.
The whole body is connected.
Fascia layer is wrapped in the entire body it’s like a spider-man suit wrapping everything
and we cannot separate it, so you treat that and it’s wrong to treat a body part because
it’s really.
So you need to look at the whole system.
You feel that tightness?
Yes it’s so tight.
That’s a lot of fibrosis.
So I’m trying to use this like as a tutorial video at the same time.
Okay So here you feel those bumps here?
Yes Okay, so that’s the fibrosis, that’s the
scare tissue.
and its a can you tell oh wow this like a small ping pong ball and I don’t know in
the camera you can visually see it the fibrosis actually sticking out.
Theres nothing here you feel that?
Yeah yeah Let’s see if you have the same thing on
the other side.
Can you tell the difference between this side and the other side?
I feel like this is bigger.
Can you feel the same?
Yes, no I feel like this is And you said it’s more sharp pain on that
side?
Yes Yeah you definitely have fibrosis on both
sides.
And you said in the occipital area too.
Okay so I’m going to do that Okay
So can you describe how the instrument feel in your body?
It doesn’t hurt.
It just feels like a rough grading, but theres no pain or anything, it’s not irritating.
The rough part is because the fibrosis and the instrument is very very small.
Yes So uhh lets see, how does this feel?
Any pain or discomfort with that?
No, not at all It’s not too bad here.
Do you feel rough or smooth here?
Smooth Yeah, that’s because there is no fibrosis
Okay When you feel rough, that’s because of the
fibrosis.
It’s a bumpy area.
Sometimes when we work with patients especially on the IT band it feels like and sounds like
a washboard.
It’s not to bad in the occipital area.
So lets move your neck left and right and tell me how that feels.
8:05 So no pain to the left.
To the right when I get all the way to the end, it goes up into here and down deep somewhere
in there.
How much from 0 to 10?
Like a 4 Like a 4, extend and flex.
Can you tell a difference with that?
I think so.
I think at the very end it doesn’t feel as tight.
It still feels pretty tight on the right side.
So lets actually lie on your back here.
So make sure its pain free okay?
Okay.
I think I’m too tall for your table.
Do you feel the tightness here?
Is that painful or is that okay?
It’s okay, it actually feels good Okay.
Any head trauma?
No.
Do you still feel the headache or the headache gone?
The headache is actually gone.
Any pain or discomfort with that?
I mean it kind of hurts where your fingers are.
Make sure you let me know okay?
It’s not unbearable, but I feel it.
Well make sure you don’t feel any discomfort.
Tuck your chin.
Shrug your shoulders.
10:30 Alright lets sit up.
Lets turn left and right and tell me how this feels.
Okay still on the right.
I feel like I have more range of motion, but it’s still going down in there.
And how much from 0 to 10?
Maybe a little less like I would say maybe a 3.
It feels deep.
It feels deep in that area?
Yes And flexion, extension is fine?
Oh look at that.
It’s like full range of motion in flexion and extension.
Okay and this doesn’t hurt quite as much and I feel like I could go farther.
I don’t expect you to gain a lot of flexion, because of the rod.
Yes I’m fused at those two levels.
So lie on your back.
So you feel it deep in this area?
Into the middle of my neck and back.
In here?
When I turn that way yes.
Is that painful?
No I mean it’s kind of a good pain.
It just feels really tight.
Yeah.
Okay turn around sit up tell me how you feel.
Okay definitely less pain and I think full range of motion.
I still feel some tightness when I do this and a little bit of pain.
How much from 0 to 10?
Maybe a 2 Okay
Not in the middle just down the top of the trap.
This is much better.
This is much better, okay so you feel it on the top?
Okay lets lie on your back.
Is that painful?
Yes 13:06
So it feels better and I definitely have more range of motion.
I still feel some tight maybe a little pain maybe a 2.
I feel it there.
So what I want you to do is 10 turning to the right.
If you’re not counting we are going to do 200.
And relax.
Okay drink some water.
How’s that?
It’s much better.
I feel a twinge.
But the pain?
But much more movement without that sharp pain.
So flex extend.
That’s a good range of motion.
I think that’s your normal extension.
It feels just a little tight now, but I don’t feel that sharp pain that was going on there.
You have a big scare tissue so we need to work on it a little bit more.
Okay To get to full range of motion.
So can you tell me what you think about the ASTR treatment.
It’s great so far, yeah it’s amazing really.
Yeah, thats good thank you.
Thank you Thank you so much.