Post Rehab Challenge

Here is an interesting case study you might like to figure out. You receive a post rehab referral from a local rheumatologist. The client is a 48 year old female with a history of rheumatoid arthritis and two recent motor vehicle accidents (the last accident was 5 months ago) with subsequent cervical injury. She completed a course of chiropractic care to manage the cervical pain. She no longer has cervical pain and she full cervical ROM but she complains of right shoulder pain. The shoulder pain occurs with overhead activity and movements across the midline of the body. She also has pain at rest along the lateral aspect of the right shoulder in the area of the deltoid. Her x-rays after the second accident show no fracture. The shoulder pain seems to occur with cervical right side-bending and right rotation. X-ray and MRI of the right shoulder show are unremarkable. What cervical nerve root innervates the lateral aspect of the shoulder? How does right cervical sidebending/rotation effect the client's shoulder pain? Please email your responses to this case study to DrMike@postrehab.com.

Dr Mike