The Fascial Manipulation Method is a publication featuring actual case reports. This publication is dedicated to the deepening our understanding of the common dysfunctions we encounter in our clinical practice, how they present and how they can be treated with Fascial Manipulation. Professionals tell us their cases, accurately describing the patients symptomatology, the working plan they have chosen and the results obtained due to the treatment. The names of the patients have been modified for privacy reasons
Clinician: Gentile Sabrina
A 45-year-old left-handed female hairdresser, non-athlete, mother of two young children (the youngest 10 months old), presented with SI PA in the anterior cervical region extending toward the left mandibular area, radiating with paraesthesia to the left hand at night when holding her baby to sleep. The symptoms had been present for approximately five months and, for the past 20 days, occasionally also involved the right hand.
She also reported concomitant pain in the left shoulder, partly due to occupational overuse, but exacerbated following a whiplash injury that occurred approximately 15 years ago.
The SI PA had a spontaneous onset, with a maximum intensity of 5/10 and a minimum of 2/10 on the NRS, presenting as a continuous pain that interfered with swallowing. A night-time bite was recommended for a suspected temporomandibular disorder, but the patient has not yet used it.
Her medical history revealed multiple whiplash episodes, the earliest 15 years prior. Since then, she occasionally experiences cervical pain but denies headaches or migraines. She has never undergone surgery, and both deliveries occurred via natural birth.
The working hypothesis is that the whiplash injury 15 years ago triggered cervical dysfunctions with descending repercussions involving the upper limbs.
Motor and Fascial Assessment
Motor testing was performed for CL, CP3, and HU SIN:
- CP3: no range-of-motion limitation.
- CL: reduced range with onset of SI PA during ante- and retropulsion (worse in retro), with full motion preserved in the horizontal and frontal planes.
- HU SIN: mild anterior pain (PA CONC) during antepulsion, absent in retro and other planes.
Transverse palpation was performed on CP3, CL, HU SIN, and DI LT:
- CP3: densification at AN CP3 LT and RE CP3 bi.
- CL: densification at AN-RE bi, tenderness also at LA bi, though less pronounced than in the sagittal plane.
- HU: densification at AN, with irradiation toward AN DI.
Given the findings, treatment was focused on the sagittal plane. Longitudinal palpation revealed:
- CP2: no densification.
- AN SC LT: densification.
- AN DI LT: densification.
Treatment
The following points were treated:
RE CP3 BI, RE CL BI, AN CL BI, AN HU LT (subsequently disappearance of AN DI LT and AN SC LT), AN CP3 LT.
Post-Treatment Assessment
Post-treatment motor verification showed improvement of cervical motion in the sagittal plane, with resolution of SI PA and decreased pain in the left shoulder.
A follow-up session was scheduled in 10 days to evaluate treatment outcomes and determine the need for further intervention.