Medication and Physio working together

Case Study – Medication and Physio working together


This 51 year old lady has been suffering with severe right sided neck, back and arm pain for 4 years.

Her pain began when she turned her head quickly. She felt a sudden sharp pain. Over the last 4 years this pain has become more and more frequent. When she came for treatment she was waking every night because of the pain. She felt her pain constantly.


This lady came to London Pain Clinic for a review of her situation. This resulted in a full assessment, prescription of new pain relieving medication, and a referral to physiotherapy.

Physiotherapy Assesment

Physiotherapy assessment revealed a very stiff neck and back, and high tone/muscle tension in the muscles of her upper shoulders and neck. The joints of the neck were extremely tight; in particular the facet joint C2/3. Her nerve system was also very tight and sensitive. It seems that the initial injury was a sprain of the facet joint in the neck. Unfortunately this had been followed by much muscle spasm, which was not helped by her stiff upper back posture. Gradually an increased sensitivity of the nerve system developed due to the ongoing pain.

Physio treatment for this problem has been three-fold.

  • Manual physiotherapy techniques to improve the mobility of the C2/3 facet joint.
  • Specific stretching exercises to improve thoracic movement and improve posture.
  • Gentle stretches to reduce sensitivity of the nerve system.


This lady is still receiving treatment. However, after 3 physiotherapy sessions her pain is not waking her and she has times in the day when she is pain free. She has more control of her pain and has a home exercise program to improve her stiffness and posture even further. In short she is very happy, and has made a real break through with her pain.

Links for Physical Therapies for Pain Management

Links for Physiotherapy

Links for Physical Rehabilitation Therapy