"Physiotherapy Case Study: Neck Pain"

John Gonzalez, Virtual Physiotherapist at Teladoc Health UK, discusses his recent treatment of neck pain.

Patient history

My patient had a history of neck pain which was on and off over the years. Generally, they were able to cope with it, but it had recently become worse and was affecting their sleep and starting to really annoy them.

It had started to affect their work, and social life and was having a negative effect on relationships as they were more irritable.

Being based in a small town in Scotland made it harder to access physio services on the NHS and the choice of private physiotherapists in the area was limited.

Rather than just doing the usual grin-and-bear-it routine they were used to when they had a flare-up, they got in touch after seeing an email introducing our services.

Meeting and assessing the patient

At first, the patient was a little hesitant but willing to ‘give it a go’ after I explained the process and how I thought I could help.

Going through the history, a couple of work-related issues seemed to jump out which were contributing to the condition and driving the recent increase in symptoms.

Firstly, their role at work was a manager of a branch, while also on the floor dealing with members of the public. The work was carried out on laptops on top of fixed-standing desks, with a one-size fits all approach.

Laptops are seldom good for the shoulders/ neck/ hands and comfortable to use all at the same time – usually it puts more pressure on one of these areas and in this case, it was the patient’s neck.

Secondly, due to their dual role, they often stood in the same position for long periods and found that, although standing, they didn’t move their head and necks much.

The pain would build through the day and would peak around the time they went home, hoping to relax; but the pain and discomfort were having a negative impact on that as well.

The third main issue identified was the stress levels in her job which had recently increased with her role of managing the branch. This had an impact on all the aspects of her neck pain – not moving as much, being glued to the screen to get the extra work done, and not taking the time to care for her own well-being.

Treating the issue

Thankfully, the patient recognised the need to move their shoulders and neck more and could identify the position which was causing the issues quite easily.

That was a nice easy fix – some gentle stretches to target the painful areas were taught and emailed to the patient, which they would then do through the day at work.

This was easier than assumed as they didn’t take long, so could be done between customers at regular points throughout the day and also when doing their managerial work on the computer.

Alongside, advice was given regarding the laptop set-up to make it better suited to take pressure off the neck. The branch already had the equipment in a box in the back but hadn’t set it up.

After explaining the principles of good set-up and showing my laptop set-up (separate keyboard, wireless mouse, laptop stand), they got on straight after the call.

The results

One week later, the neck pain was significantly better – they no longer had pain as such, just a little niggle every now and then, which was a lot easier to cope with and significantly better.

Sleep had improved, stress levels reduced, irritability eased and they were generally happier with all aspects of work and life – it is amazing how negative constant low-level pain is without someone realising it.

It was a great result, but the speed and level of improvement being a good surprise to me.

That alone was a great outcome, but as manager, they were perfectly placed to make changes to all the laptops and wark-stations in the branch so that the whole team could benefit.