Chiropractic Patient Case Study: Traumatic Injury to the Cervical Spine

A 25 year-old college student, Stephen, is active in sports, especially basketball. Playing in an intense pick-up basketball game one afternoon he went up for a rebound and collided with another player trying to get the ball. He felt his neck "wrench" backwards, experiencing an immediate pain in both sides of his neck. He played for a few minutes longer, but his neck was hurting and he headed for the lockers. That evening, he felt stiffness and pain in his neck and he had trouble turning his head.

Patient History and Examination
The chiropractor took a careful history about Stephen's injury. He noted that Stephen did not report pain down his arms and there was no loss of sensation or weakness. He was not experiencing headaches, dizziness or nausea. He did have soreness in his neck, sometimes a burning pain, and stiffness. He was still having trouble turning his head.

Upon examination, the chiropractor found no signs of a neurological deficit. There was no loss of sensation, weakness or abnormal reflex signs in the upper extremities. There was marked muscle guarding in the neck on both sides with tenderness to direct touch. Static and motion palpation of the cervical spinal joints indicated bilateral restrictions in motion with tenderness and tautness in the surrounding soft tissue. The chiropractor noted the specific motor units or vertebral segments where retriction in lateral flexion was found and the direction in which these motor units were locked. These were noted as subluxations in the chiropractor's notes.

Radiographic Imaging Not Necessary
Because there was no indication of fracture in the spine and because Stephen had no prior history of neck or back pain, no x-rays were taken. The chiropractor explained to Stephen that if his problems persisted or worsened he might need x-rays or imaging studies of the neck.

Making a Diagnosis
The diagnosis of Stephen's injury was acute cervical sprain, which was due to the trauma of the basketball injury. The blow caused micro-tearing of the ligaments and muscles of the neck with accompanying inflammation. The trauma was caused when his neck was forcefully wrenched backward. The effects of the blow caused the spine to lock up, lose motion between the segments and facet joints (the important gliding joints in the neck).