Module 13 Case Studies: Integration of Physical Agents

Integration of Physical Agents Case Study: Charlotte 

Charlotte is a 50-year-old secretary who presents to the outpatient physical therapy clinic seeking relief from symptoms sustained during a motor vehicle accident 3 weeks ago. Since the accident, she reports the following: 

• Persistent neck and upper back pain 

• Occasional tension headaches, especially when sitting at her desk 

• Intermittent paresthesia (numbness and tingling) in her right hand, especially when using a keyboard or reaching forward 

• Difficulty maintaining upright posture during work 

• Disrupted sleep due to discomfort 

• Increased anxiety about not being able to return to teaching aerobics, which she did five evenings per week prior to the injury 

She denies any history of seizures, heart conditions, or previous surgeries. Her orthopedist ruled out fractures and cleared her for conservative PT. However, during her subjective re-evaluation today, she reports increased sensitivity in her right upper extremity during light palpation and mentions that the tingling in her hand seems more frequent over the past few days. She is currently taking over-the-counter NSAIDs for pain and occasionally uses a soft cervical collar. 

Her goals are to: 

• Return to work full-time without pain 

• Resume teaching aerobics within 6–8 weeks 

• Improve posture and sitting tolerance 

• Alleviate hand tingling and restore functional use 

Short-Term Goals: 

• Decrease neck and upper back pain from 6/10 to 3/10 in 2 weeks 

• Reduce frequency and severity of right hand paresthesia within 2 weeks 

• Improve cervical and upper thoracic posture awareness in seated position 

Long-Term Goals: 

• Return to teaching aerobics within 8 weeks 

• Restore normal function of the right upper extremity for ADLs and work-related activities 

• Maintain upright posture for >60 minutes without discomfort