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.

Today’s article is dedicated to wrist pain. Marco S. is a fascial therapist who will discuss this topic.

“Francesca is a full-time social worker. During there free time she practices Zumba. She came tomy office because of a pain in her left wrist, very severe in some moments of the day or in some articular positions of the wrist. She had surgery some years ago, because of a cyst (1.3 cm.) positioned near the navicular boneof the wrist, specifically, in the extensor retinaculum. Before of the surgery, Francesca wascomplaining about a very significant pain, felt even at rest, avoiding the use of her left hand duringdaily activities.

Currently, her pain has been present for seven years, with a fluctuating trend,with the most recentflare-up four months ago. The patient states that the last painful episode occurred when she was,together with a colleague, transferring a patient from bed to wheelchair. Furthermore, she is complaining about some frontal-temporal headaches, which improves after NSAIDs.

During Movement Verification, I examined the following segments: Ca, Cu, Cl, Hu.Hu segment wasn’t painful and showed no movement deficit while the other segments werelimited, especially in the horizontal plane.Palpation Verification has demonstrated a lot of densified and painful CCs (the patient has a tactile hyperalgesia), without radiation. Since the more densified points were in the horizontal plane, we decided to start treating thisplane, more specifically the sequence of Ir Ca, Ir Cu, Ir Cl, balancing it with Er Ca, Er Di.

After treatment, I have repeated the Movement Verification, and I have seen that the patient wasable to perform flexion, extension and supination movements of the wrist, without pain, while painpersisted in ulnar deviation, as before treatment. She noted more fluidity in the wrist movements, specially in supination. Neck was painful, but less than before the treatment (VRS 3 compared with7).

We scheduled an appointment for a second session. Francesca came back to my office after ninedays, reporting a discrete, painless mobility of the wrist in flexion and extension with a good ROM, although less than at the end of the previous session. She reported a slight pain (VRS 2) during supination of the wrist. Furthermore, she reported a slight pain ( VRS 2) in her neck during flexion,while rotation was totally painless. Moreover, she said that in the last nine days, she hadn’t any headache. After the Movement and Palpation Verification, we have proceeded with the treatment of the densified CCs on the horizontal plane.

After 2 weeks the patient reports to be satisfied of the results. A ROM limitation persists in ulnardeviation (VRS 2). She reports being able to carry weights and trays without any difficulty.The FM treatment has cured the pain of Francesca, allowing her to continue her previouslyinterrupted daily activities.”

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