A 56 yo female software analyst presents with a 7-week h/o l…
A 56 yo female software analyst presents with a 7-week h/o left-sided neck pain that radiates down her posterior arm to her left elbow. She denies trauma or any change in activity that is related to the onset. Radiograph shows degenerative changes at C6-7, C7-T1 greater than C4-5 with osteophytes at C6-7 (Refer to below image). The patient had a 1-week trial of steroids that resulted in short-term relief of symptoms. Unfortunately, the symptoms returned 1-week after she completed the steroid trial. Her PMH is unremarkable. The patient rates her pain at 4/10 at best and 10/10 at worst. The quality of the pain is sharp or pinching. It worsens with any sitting or standing activity including driving, as well as overhead reaching. The pain is lessened by lying in supine or sidelying. Her current exercise regime is treadmill walking 5 times a week. She continues this routine but with symptoms. Her Neck Disability Index score is 52%. She reports functioning at 60% of normal function. The following are her physical exam findings: Posture: mild protracted shoulders, moderate forward head, moderate thoracic kyphosis Shoulder A/PROM: WNL with overpressure; no reproduction of sx