Effective treatment of a patient with chronic cervicobrachialgia

Optimising the management of patients with chronic neck pain (NP) is one of the pressing issues in modern medicine. We present a case study of a 38-year-old patient with chronic musculoskeletal NP and shoulder pain, increased anxiety, and severe limitation of movement in the cervical spine, which arose against a background of prolonged static loads, whiplash injury, and previous episodes of NP. The patient had suffered from NP for 5 years, with no effect from conservative treatment methods or surgical treatment (decompression surgery with stabilisation) at the cervical level. A comprehensive approach was used in the patient's treatment, combining educational discussions, kinesiotherapy, and optimal pharmacotherapy. Previously, the patient had not been prescribed therapeutic exercises, nor had he been given recommendations on ergonomics, lifestyle, and physical activity. Against the background of complex therapy, including the formation of correct ideas about the causes and factors supporting pain, lifestyle correction, training in the rules of ergonomics in combination with individual therapeutic exercises and pharmacotherapy with Dexalgin, a gradual decrease in pain and improvement in functional activity were observed. The use of Dexalgin made it possible to quickly reduce pain and increase adherence to therapeutic exercises. As a result of comprehensive treatment, after 3 months, pain intensity decreased from 6 to 2 points on a numerical rating scale, the Neck Disability Index decreased from 72 to 12%, and the severity of anxiety disorders on the Beck Anxiety Inventory decreased from 34 to 12 points. Issues related to the optimisation of management of patients with chronic musculoskeletal pain are discussed.

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