Cervical Degenerative Joint Disease

Miss Tedo is a 69 year old female who presents with cervical degenerative joint disease. She is seeking physical therapy to help with the limited range of motion due to neck stiffness, hypertonicity in her cervical paravertebral muscles, postural education, and pain reduction. Cervical degenerative joint disease is the wearing down of the vertebral joints at the cervical spine, or the neck. There are different possibilities to the pathogenesis of this disease including axial neck pain, radiculopathy, or myelopathy. This particular patient seems to be showing signs of radiculopathy, which is a dermatomal or myotomal issue, due to the radiating pain down her right upper extremity (Todd, 2011). As the joint wears down, the cartilage is begins
Ultrasound will be used to help improve the hypertonicity of the posterior cervical muscles. Therapeutic ultrasound is a form of mechanical energy which is transferred through conversion. It promotes tissue healing by transmitting waves using gel as a medium. Another modality which is mentioned is TENS, or transcutaneous electrical nerve stimulation. TENS is a portable, battery powered pulse stimulator used primarily for take home use of the patient. It is used for pain management. Cervical traction is also a modality in the plan of care for Miss Tedo. Traction is the drawing or pulling apart of the vertebrae at the cervical spine to relieve pressure. It is also a form of mechanical energy which performs the distraction of vertebrae by the use of a pulley system hooked up to a machine (Behrens & Beinert,
Each modality chosen by the Physical Therapist is picked specifically to provide relief, comfort, and improvement for the patient. Electrical stimulation and ultrasound help to reduce the muscular hypertonicity of the cervical paravertebral muscles. Though not discussed in detail throughout this paper, EMG biofeedback is used to improve postural awareness, and also in junction with electrical stimulation and ultrasound to reduce muscular hypertonicity. Finally, TENS, thermal agents, and cervical traction is utilized to reduce the patient’s pain. Each of these modalities does a specific task to help Miss Tedo return to her prior level of