The Fascial Manipulation Method is a cycle of articles dedicated to the understanding of themost common dysfunctions we meet during our clinical practice, specifically theirmanifestation and treatment with Fascial Manipulation. FM specialists report clinical cases,accurately describing their symptomatology, the chosen work plan and the resultsobtained, thanks to the treatment. For privacy reasons, the names of the patients have been changed.
Clinician: De Vecchi Michele
A 55-year-old female patient, employed as a florist, presented to the clinic.
The patient reported pain radiating from the neck to the elbow, localized in the left posterolateral region. The symptoms had arisen approximately one week prior, spontaneously and without any apparent triggering event. This was the first episode of such symptoms reported by the patient.
The intensity of the pain at rest was quantified as approximately 5/10 on the Numerical Rating Scale (NRS), with peaks reaching 8/10 during lifting of heavy objects and during extension movements of the shoulder and elbow. Pain improved with rest and the application of heat.
During anamnesis, the patient reported a previous episode of right shoulder periarthritis, which had resolved about one year earlier. She also described episodes of bruxism, the origin of which remained undefined.
Further anamnesis revealed a history of cervical whiplash trauma occurring approximately 20 years ago, as well as a childhood injury (at the age of 3) involving the third and fourth fingers of the left hand, which had resulted in partial amputation of the distal phalanges followed by surgical reconstruction.
It was hypothesized that biomechanical compensations secondary to the left-hand trauma had developed, combined with residual cervical stiffness due to the previous whiplash injury, and that the current scapulo-humeral pain on the left side had manifested in association with a period of particularly intense work activity.
Motor verification of the involved segments revealed mild cervical pain during right rotation and a moderate strength deficit during forward flexion of the left humerus. Palpatory verification of the left carpo and scapula showed areas of densification on both the frontal plane and the AN-ME diagonal, with the latter being more significantly altered. Treatment was therefore directed toward the AN-ME diagonal, focusing on the left carpo and humerus.
Given the posterior localization of some of the symptoms, the posterior diagonals were also evaluated, revealing densifications in the RE-ME one; treatment was thus applied to RE ME DI SIN and RE ME SC BI.
At the end of the session, the patient reported a sensation of lightness, and motor verification revealed a significant improvement in strength.