MASSAGE Background A 30-year-old stockbroker complains of chronic cervical myalgia (“My neck hurts”). There was no prior history of trauma and his family physician reported that his x-rays were within...

MASSAGE

Background A 30-year-old stockbroker complains of chronic cervical myalgia (“My neck hurts”). There was no prior history of trauma and his family physician reported that his x-rays were within normal limits without evidence of degenerative changes or loss of disk space height. The patient reports no radiation of pain into the shoulders or upper extremities, but does complain of restriction in rotating his head to the left. The patient states that he spends many hours each day at work cradling a telephone with his right side.

Impression “Occupational neck”: Right upper trapezius and sternocleidomastoid (SCM) muscle spasm.

Treatment Plan The patient was placed in a forward seated position with the head and neck supported by pillows on the treatment plinth. The arms were likewise supported by a pillow in the lap. A small amount of prewarmed massage lotion was applied to the right upper quarter region and a Hoffa massage commenced with light effleurage stroking begun to the SCM and upper trapezius muscles. The light effleurage stroking was followed by several minutes of deep effleurage strokes, which identified several “trigger point” areas in each muscle. Petrissage was directed at each trigger point area for approximately 30 seconds; then the massage concluded with several more minutes of deep, then superficial, effleurage strokes. At the completion of the massage, excess lotion was removed; then the patient was instructed in cervical and upper quarter active range-of-motion exercise. The patient was encouraged to perform his home range-of-motion exercises each morning and evening.

Response The patient reported immediate relief of his symptoms following the initial session of massage. He reported the ability to fully turn and bend his head and neck. The patient returned for two additional sessions of massage treatment and was educated as to postural habits that triggered his condition. He continued his range-of-motion exercises twice a day, added isometric strengthening exercises to his daily regimen, and monitored his postural habits at work.