Experiencing discomfort after twisting his neck during a fall while playing basketball at school.

Since the incident, he has been experiencing pain on the left side of his neck when moving his head. He described feeling pain when turning to look over his left shoulder and reported that the tension in his left neck muscles is particularly severe in the morning, causing pain when getting out of bed each day.

[Initial Symptoms]

Interview:The patient has been playing basketball for about two years in both school club activities and an external club and has never experienced any significant pain in any part of his body before. A few days after the injury, he went to the hospital with his mother as a precaution. The doctor said, “There are no abnormalities on the X-ray, so you should be fine. It should heal within a “few days,” and only prescribed a compress. However, after approximately two weeks of no improvement, they decided against returning to the hospital, assuming the same type of assessment would be given. The mother chose to bring him here this time based on the father’s positive experience with this clinic.

Visual Inspection:No significant abnormalities were observed. There was no noticeable difference in shoulder height, neck tilt, or pain-triggered avoidance posture. It appeared that the pain was not severe in a static position.

Static Palpation:There was slight tension detected in the left cervical area , but there was minimal discrepancy noted.

Motion Palpation:Pain and range limitation were observed during left rotation. Pain provocation was also confirmed during passive motion testing (where the practitioner moves the patient’s neck while the patient remains relaxed).

Orthopedic Tests:

  • Cervical Compression Test: (+) Positive at the left C5 area
  • Valsalva Test: (–) Negative, for ruling out risk factors

Muscle Strength Examination:No issues were found with the strength of the trapezius, sternocleidomastoid, or scalene muscles. However, pain was induced during the testing posture.

[Treatment Content]

Based on the examination results, I diagnosed him with cervical facet joint syndrome at the C4-C5 level.

Reasons for the Chiropractic Diagnosis:

  • There was significant pain provocation upon passive movement.
  • The pain was localized to a specific area.
  • The pain was limited to certain ranges of motion and directions.

These factors strongly suggested the possibility of facet joint syndrome, and based on my experience, I informed the patient that improvement would likely occur after just one treatment, considering his age and symptoms. Although it is somewhat risky to communicate such expectations before treatment, I felt confident and assured based on my experience.

During the treatment, I only aimed to slightly alleviate the muscle tension around the painful area and did not manipulate the surrounding muscle groups extensively. This was because there was a concern that relieving the muscle tension could increase the burden on the facet joints. The muscles maintain proper tension to resist gravity and support the body in a normal posture; thus, simply relaxing them is not necessarily beneficial.

I performed muscle relaxation on the neck muscles within an appropriate range and proceeded with the adjustment at the C4-C5 level. The treatment was completed in approximately 30 minutes.

[Prognosis]

After one session, the patient was able to turn his head to the left without pain and with smooth motion, so I concluded the treatment. I advised him to avoid bathing on that day and suggested monitoring his condition.
The following week, when the father came in for maintenance treatment, I inquired about the son’s status and learned that he had not reported any further symptoms since then.

[Practitioner’s Opinion]

The symptoms observed in this child were purely due to issues with the cervical facet joints. Chiropractic adjustments proved to be the most effective treatment, leading to a quick improvement.
Such symptoms typically do not resolve with conservative treatment (i.e., immobilization), although there are rare cases where the facet joints may spontaneously unlock. Conversely, immobilization can lead to muscle weakness and necessitate rehabilitation afterward.
To make an accurate assessment, it is essential to understand and address the condition of the facet joints. Additionally, treatments that involve forcefully cracking the neck can be dangerous if done without proper evaluation.
What is crucial is the ability to determine whether the symptoms are appropriate for chiropractic care. If there is any concern about potential risks, it is important to recommend a visit to a hospital.
This child’s case exemplifies how accurate treatment led to symptom improvement after just one session, taking all these factors into account.
If you or someone you know is experiencing similar symptoms, please visit my clinic, Spine Chiropractic, located just one minute from Bashamichi Station, eight minutes from Nihon Odori Station, seven minutes from Kannai Station, and twelve minutes from Sakuragicho Station. I will provide dedicated and sincere care.