Case Update: "Threatless" Part 2 | Modern Manual Therapy Blog

Case Update: "Threatless" Part 2


One of my more interesting and memorable cases from this past year I thought of as "threatless" when I would treat her. Here is the review of her case from last year.

After about 3-4 more months of at first weekly, then progressing to bi-weekly appointments, her cervical ROM improved by about 10 degrees bilaterally, and mandible depression from 13 mm to about 23 mm. It was enough to finally get routine dental work done again. She was very pleased.

Every once in a while, her lumbar condition would flare up and we would talk about how fearful she was of her lumbar spine, and how she was not anxious in the least about her head, neck, or jaw. One day she told me that she has no recollection of the accident, or several days afterward. The lack of threat was due to no memory of it!

She certainly remembers having lumbar pain prior to her surgery, and continuing to have it after the surgery. I never did convince her to start any kind of formal program for her low back, but she did respond favorably to repeated extension in standing.

This reminds me of a study a blog reader once referenced to me, but did not get the citation. It was a Canadian researcher who had evidence that there was a "blame" aspect of chronic whiplash that other conditions did not have. It also made me wonder about this study by Jull, et al that Body in Mind reviewed last year. That study both validated the hit and miss results I have with chronic whiplash, and also made me think, what hope do we have for this population? Perhaps some day in the future, we will be able to alter the memory of the MVA to be less traumatic, thus reducing the threat and the resultant neuroimmune reaction.

What do you think?

Keeping it Eclectic...

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