Prospective Case Study in Treatment of Cervical Rib at C4 Vertebra
| dc.contributor.author | Srijeeta Biswas | |
| dc.contributor.author | Kusum Agarwal | |
| dc.contributor.author | Ritu Patwari | |
| dc.date.accessioned | 2025-11-29T07:12:00Z | |
| dc.date.available | 2025-11-29T07:12:00Z | |
| dc.date.issued | 2024-10-20 | |
| dc.description.abstract | Background: Cervical rib is a rare congenital anomaly, usually from C7. Most are asymptomatic, but incomplete ribs can compress neurovascular structures, especially the brachial plexus, causing pain, paresthesia, and weakness. This case reports a 19-year-old male with a rare CR at C4, presenting with severe right-sided neck and shoulder pain, tingling, and functional limits after prolonged backpack use. Diagnosis was confirmed via X-ray. Purpose: To evaluate whether a non-surgical, evidence-based physiotherapy program could reduce pain and improve function in a patient with a rare symptomatic cervical rib. Method: A qualitative case study was conducted. Assessment included muscle strength, shoulder range of motion, nerve tension tests (ULTTs), and special tests (Adson’s, Roos). The baseline Numeric Pain Rating Scale (NPRS) was 8/10; the Neck Disability Index (NDI) was 34 (severe). Intervention: Weeks 1–2: Neural mobilization (median, ulnar nerves) and ultrasound therapy (3 MHz, 2 W/cm², 4 days/week) → NPRS reduced to 6; NDI to 26. Weeks 3–4: Neural mobilization plus Muscle Energy Techniques (scalenes, upper trapezius) → NPRS 2; NDI 20. Weeks 5–6: Maintenance sessions (3 days/week) sustained improvements. Results: Pain and functional scores improved steadily: NPRS from 8 to 2; NDI from 34 to 20 by Week 4, maintained through Week 6. Conclusion: A non-surgical, phased physiotherapy program—combining neural mobilization, ultrasound therapy, and muscle energy techniques—effectively reduced symptoms and disability in a rare high-level cervical rib case. | |
| dc.identifier.issn | 2393-8536 | |
| dc.identifier.issn | 2393-8544 | |
| dc.identifier.other | https://doi.org/10.15415/jmrh.2024.111004 | |
| dc.identifier.uri | https://demodspace.chitkara.edu.in/handle/123456789/24 | |
| dc.language.iso | en | |
| dc.publisher | Chitkara University Publications | |
| dc.subject | Cervical rib | |
| dc.subject | Neural mobilization | |
| dc.subject | Muscle energy technique | |
| dc.subject | NPRS | |
| dc.subject | NDI | |
| dc.subject | Thoracic outlet syndrome | |
| dc.title | Prospective Case Study in Treatment of Cervical Rib at C4 Vertebra | |
| dc.type | Article |