Our Patient
Our patient presented with persistent neck and interscapular pain lasting more than five years, with a history of overhead sports and a prior car accident. The patient had been unsuccessfully treated elsewhere.
The Challenge
Pain had begun prior to the patient’s car accident. The patient had received a brachial plexus hydrodissection, which failed to alleviate pain. An apparent misunderstanding of the underlying issue led to suboptimal treatment outcomes. During our assessment, the patient exhibited sporadic and involuntary scapular twitching, making for a complex diagnosis. Previous treatments had exacerbated the condition.
Our Diagnosis
We conducted a thorough examination to identify physical abnormalities, muscle imbalances, nerve entrapments, and structural irregularities. MRI indicated small disc bulges in the C4-C6 region, with mild degenerative facet arthropathy. We concluded that the patient was experiencing bilateral scalene syndrome, dorsal scapular nerve entrapments, periscapular fascial distortion, and other musculoskeletal issues.
Our Treatment Approach
To alleviate pain, we used focused shockwave therapy to address specific muscle attachments. DNS therapy was used for scapular stabilization, and hydrodissection was performed to target nerve entrapments.
Our Results
Following our treatment plan, the patient experienced significant pain relief, and the involuntary scapular twitching decreased. The patient’s overall function substantially improved.
About the Author
Dr. Lev Kalika is a world-recognized expert in musculoskeletal ultrasonography, with 20+ years of clinical experience in advanced rehabilitative medicine. In addition to operating his clinical practice in Manhattan, he regularly publishes peer-reviewed research on ultrasound-guided therapies and procedures.
Dr. Kalika is an esteemed member of the International Society for Medical Shockwave Treatment ((SMST), and the only clinician in New York certified by the ISMST to perform extracorporeal shockwave therapy. He is also an active member of the American Institute of Ultrasound in Medicine (AIUM), and has developed his own unique approach to dynamic functional and fascial ultrasonography.
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