Pain in the neck

Patient, 27 years old.
Pain in the left occipital region. All movements in the neck are painful with decreased ROM. Very painful on palpation atlanto-occipital and atlanto-axial joints.
Symptoms last for 2 weeks. Worse in the night, one night pain in the left half of the head from the occipital region to the front of the head with nausea.

Therapy on the first treatment - gently traction, massage, laser, and lateral flexion to the left (removed pain).
Home tratment: Posture instructions (for sleep), ergonomic adaptation of the computer station; cervical retraction and lateral flexion with overpressure every two hour during the day.

Two days better, (slightly painful in the night) then one night worse.

Second treatment (after one week) - no pain in the left half of the head, but still atlanto-occipital and atlanto-axial joints very painful on the palpation.
Therapy: Mobilization in lateral flexion, traction, massage, laser.
After that in the night and morning worse.

Any ideas?
I am going on a vacation what can I tell her to do?

[arunja]

Hi

I would like to tell you about the occipital pain, pain in the occiput should be diagnosed differentially from cervical spondylosis. I think there is no chance of spondylosis. But usually upper neck pain may be caused due to the muscular spasm of the suboccipital extensors. It may be a result of bad posture.

After all your stretching programmes, you can advice him a good posture especially tuck in head which releases the load on muscles. Occupational modifications should be ruled out , which may aggravate the condition.