Some days there are just really hard cases that take extra effort and work. They are a great motivator, and they keep things interesting. How you face them can determine success or failure. There is a blog I’m following about a lady training to run a marathon to benefit leukemia, and she shares all about what she calls Mental Toughness as she overcomes her trials. We can as she says work within our limitations to exceed our expectations.
Well, I have a patient that requires some mental toughness, nothing like preparing for a marathon, but we can apply the analogy. This patient don’t fit the textbook. They have neck and shoulder pain that at times will radiate to the arm. They had no apparent cause for this injury that just began hurting a few weeks back. When they first came in it seemed like standard lower Cervical, upper Thoracic joint dysfunction, with pain seeming to center there at the base of the neck and radiate out.
After the first treatment we were getting symptom relief in the neck, but the area over their clavicle hurt. Moving out from the neck I knew the scalenes were tight, and that is a typical trigger point referral, we treated that, with limited success. Again the center of the pain moved further out. Now it seems that the pain is centered just below her collar bone (clavicle). Her clavicle seemed to be moving to much indicating a possible sprain, but nothing major. This is a major area for the nerves in the arm to come through often referred to as the thoracic outlet. The patient, however, is experiencing little if any of the symptoms of Thoracic Outlet Syndrome down their arm. So right now we are treating the symptoms in the hopes of relieving pressure on the root cause, allowing it to heal, while still hunting for the specific diagnosis. We are getting some relief, but not as much as we’d like. If I thought a referral would help I’d happily send them where they need to go. It’s just a more difficult case, but because we’ve had trials in the past we are strong enough to overcome this trial also, and this trial will teach us something and make us stronger.
No matter what we are doing in life we face challenges, and they can make us stronger, or we can give up. I choose to get stronger and become better. I hope that I can instill that same desire in my patients.