Patient Success Stories
Mary is a 25-year-old woman who has had pain for 5 weeks since she suffered a whiplash
injury. Her neck pain started a few hours after her stationary car was rear-ended
in traffic. She also initially complained of stiffness and inability to turn her
head comfortably which continues to date. After an assessment including a physical
exam without any neurologic signs and a non-concerning X-ray, she was discharged
home. Mary returned to the doctor due to continued pain and stiffness despite conservative
care. She was then referred to a physician to perform a CMAP evaluation on her
cervical region. Based on the CMAPPro report,
the treating physician diagnosed an acute and active strain of her sternocleidomastoid
and paracervical muscles. A treatment plan was devised and Mary went through physical
therapy to target these particular muscles. Given
the presence of muscle spasm, which was elucidated by the CMAP evaluation, her physician
took care to avoid administering TENS (transcutaneous electrical nerve stimulation)
unit therapy and instead prescribed her a muscle relaxant. Mary’s condition improved
greatly after the treatment.
Back to Top
Shelly is a 37-year-old woman who has had right shoulder pain for over 4 months.
She denies any trauma or specific event associated with the onset of her pain. Initially,
the pain was intermittent and mild, but it has increased in severity and has become
persistent in the last month since she has been carrying her newborn son. Her discomfort
is also aggravated if she falls asleep on her shoulder or moves her arm overhead
to comb her hair. She is particularly distressed with her pain because her job “on
the line” in an automotive factory, requires her to regularly lift her arms overhead
and she is having difficulties performing her work duties. In addition to a benign
physical exam with normal findings, Shelly’s X-rays were normal and the MRI results
were equivocal for a rotator cuff injury. As a result, Shelly was given a CMAP evaluation
on her shoulders which revealed acute injury to her right supraspinatus muscle.
The data collected by CMAPPro was later interpreted
by her treating physician to reveal evidence of rotator
cuff tendonopathy signs of impingement. Shelly was treated with focused physiotherapy,
iontopheresis and steroid injections. She was also given work restrictions based
upon the CMAP exam functional abilities testing.
Back to Top
Jenny is a 57-year-old woman with “pain all over,” especially at her mid-back. Her
pain started 7 months ago after she was in a minor car accident. Now, Jenny is unable
to comfortably lean on her back while driving. In addition, she has frequent headaches,
with the pain most felt at the back of her head. She has no prior history of similar
symptoms. Her review of symptoms disclosed insomnia as well. Jenny went through
multiple physical exams and various lab studies without any answer to her condition.
Her physician decided to perform a CMAP evaluation to better identify specific areas
that were injured. The objective data collected by CMAPPro
was later interpreted and revealed mild acute on chronic findings for all muscle
groups tested, along with an abnormal thoracic flexion / relaxation response. The
findings were consistent with multiple trigger points, and her CMAP report suggested
that possible conditions to consider included myofascial dysfunction.
Jenny’s treating physician reviewed her history, physical exam, and CMAP
findings and diagnosed her with fibromyalgia. Jenny was given proper medication
and was also referred to a rheumatologist for continued care and has since had considerable
/ significant relief from her pain.
Back to Top
Median Nerve/Carpal Tunnel
Jane is a 47-year-old woman who presented with worsening bilateral wrist pain and
finger tingling for over 7 months. She underwent multiple physical exams. Needle
EMG and NCVs were “borderline” but were not inconsistent with Carpal Tunnel Syndrome.
She had routine labs as well as thyroid function testing, but none revealed answers
to her continued wrist pain. Just prior to possible transverse carpal ligament release,
her primary care physician decided to perform a CMAP evaluation on Jane’s Median
Nerve (which travels through the Carpal Tunnel). The data collected by
CMAPPro was later interpreted to reveal evidence of severe injury
of both her scalene muscles with a possibility of scalene muscle dysfunction (cervical
dystonia) causing median nerve dysfunction. Jane was treated with physical therapy
targeted to her scalene muscles and her wrist pain resolved after treatment.
Back to Top
Lower Back Pain
John is a 55-year-old man who has had lower back pain for more than eight weeks. His pain
was initially noted the morning after he had moved some boxes in the house while
doing spring cleaning. He subsequently took some NSAIDs with minor relief, and also
noted improvement of symptoms with rest. John saw his primary care physician (PCP)
who diagnosed him with mechanical back pain / nonspecific back pain and treated
him with expectant (conservative) management. However, at week eight, John continued
to complain of intermittent pain, so he returned for a follow up evaluation. Repeat
physical exams and an X-ray were all normal, so his physician recommended he undergo
a CMAP test. The data collected by CMAPPro revealed
spasm and acute injury of his quadratus lumborum muscles, so his PCP was able to
confirm and refine his original diagnosis as strain in this particular spinal region.
John received physical therapy for his quadratus lumburum muscles including relaxing
and heat modalities; He also was able to specifically
avoid spasm inducing therapies such as TENS Units thereby optimizing care for his
prolonged symptoms and finally leading to significant medical improvement and relief.
Back to Top
Hip Groin Pain
Randy is a 49-year-old police officer who has been complaining of left hip pain since
he started foot patrol 4 months ago. He complains that the pain is at the outer
aspect of his thigh and occasionally radiates to the buttocks and groin area. He
also complains of exquisite sensitivity to light touch and warm showers. Randy underwent
multiple physical exams and had a hip X-ray, but no answer was found to explain
his pain. He was referred to a physician to perform a CMAP test to rule out degenerative
joint disease and local inflammation as well as to evaluate function and range of
motion (ROM). The CMAPPro test revealed no acute
or chronic injury of any of the muscles which were tested, as well as normal strength
and ROM. Upon consideration of these results, Randy’s physician deduced that Randy’s
symptoms were not of motor, but rather purely sensory, origin.
Given a second look at Randy’s tight holster with his gun resting at his
left hip, his physician diagnosed Randy with meralgia paresthetica and prescribed
pulsed radio-frequency of the lateral cutaneous nerve. Along with tricyclic antidepressants
for his neuropathic pain, the therapies and correct diagnosis helped Randy who is
now comfortably back on his street beat.
Back to Top
Knee and Joint Pain
Mike is a 35-year-old athlete who presented to his primary care physician with 3 months
of persistent pain to his right knee. He went through the usual examination, MRI
and X-ray, but had no answers for his continued pain. Mike was then referred to
a physician to perform a CMAP evaluation on his lower back. The objective data collected
by CMAPPro was later interpreted and suggested
evidence of nerve root irritation at his lumbar spine that could be an explanation
for the pain in his knee. This information was provided to the patient and treating
physician. Mike received therapy for his back and avoided unnecessary knee surgery.
He was properly treated and has since fully recovered.
Back to Top
Ankle and Lower Calf Pain
Kate is a 32-year-old race car driver and long distance runner with right ankle
and lower calf pain for 3 weeks. The pain is noted at her right heel, sole, ankle,
and her lower calf. She notes that the pain is worse at night, but not worse when
she first stands in the morning. She describes the pain as “aching and burning”
with occasional tingling and numbness at her foot. Kate went through a long list
of physician exams including extremities exams, neurologic exams and a venous Doppler
study was performed and was negative. Kate was referred to a physician to perform
a CMAP evaluation on her lower extremities to define if she had an injury at the calf muscles
and to support diagnosis of tarsal tunnel syndrome for appropriate management. The
objective data collected by CMAPPro was later
interpreted and suggested evidence of moderate to severe acute injury of right gastrocnemius
and right medial ankle, and decreased range of motion (ROM) at right ankle during
inversion and eversion, with possible conditions to consider including peripheral
neuropathy. After treating physician review of current history, physical exam, and
CMAP findings, Kate was diagnosed with Tarsal Tunnel Syndrome secondary to posterior
tibial nerve entrapment, possibly by a space occupying mass; and associated radiation
of pain / referred retrograde pain to calf. Kate was prescribed with NSAIDs and
foot orthosis. She also obtained an MRI to rule out a space occupying lesion, such as
a ganglion cyst, in the tarsal tunnel which may have been causing Tarsal Tunnel Syndrome.
Back to Top