Provider Name & Treatment Location: Winback Clinical Case Study Series (provider and treatment location not specified in source documentation)
Key Words: Chronic cervicalgia; cervical radiculopathy; muscle spasm; neuromuscular guarding; TECAR therapy; cervical mobilization
Summary (Abstract)
This case study describes the rehabilitation of a patient with chronic cervical pain, severe muscle tension, restricted cervical mobility, radiating upper extremity symptoms, and associated dizziness. The patient demonstrated longstanding cervical dysfunction with limited improvement from previous therapy interventions.
A comprehensive rehabilitation program was implemented including cervical joint mobilization, soft tissue treatment, stretching, therapeutic exercise, patient education, and Winback TECAR therapy. In this case, TECAR therapy was primarily utilized for reduction of severe cervical muscle spasm, neuromuscular relaxation, reduction of protective muscle guarding, facilitation of cervical mobility, and preparation for manual therapy interventions.
The patient demonstrated significant reduction in muscular tension, improved cervical mobility, and improved overall comfort following treatment. What is unique about this case is that although similar TECAR device settings were used as in other musculoskeletal presentations, the therapeutic goal here was neuromuscular downregulation and spasm reduction rather than tissue-healing or loading support.
Key take-away lessons:
- TECAR therapy can serve fundamentally different therapeutic goals depending on presentation — in this case, neuromuscular downregulation and spasm reduction rather than tissue healing or progressive loading.
- In patients with osteoporosis, TECAR-assisted relaxation can allow manual therapy to proceed using low-grade mobilization techniques performed more cautiously.
- Severe, longstanding cervical muscular hypertonicity (upper trapezius, SCM, scalenes, suboccipitals, deep cervical musculature) can be a primary driver of pain, restricted ROM, and even dizziness/balance disturbance.
- TECAR’s thermal and neuromodulatory effects were clinically valuable in reducing protective muscle spasm, improving tolerance to movement and manual therapy despite a severe baseline presentation (NDI 31/50, severe disability category).
Introduction
Chronic cervical pain is frequently associated with persistent muscle spasm, joint hypomobility, neuromuscular guarding, altered posture, and movement-related fear. In patients with longstanding cervical dysfunction, persistent muscular hypertonicity can significantly contribute to restricted range of motion, pain amplification, reduced cervical stability, headaches, sleep disturbances, and upper extremity symptoms.
Management often requires a multimodal rehabilitation strategy integrating manual therapy, mobility restoration, neuromuscular re-education, and reduction of protective muscular overactivity. This case highlights the clinical application of TECAR therapy as an adjunctive intervention specifically targeting severe cervical muscle tension and spasm in a patient with chronic cervical dysfunction.
Patient Information / Diagnosis
Demographics: Female; age not specified.
Primary Diagnosis: Cervicalgia with possible cervical radiculopathy.
Condition Duration: Chronic.
Relevant Comorbidities: Osteoporosis; arthritis; anxiety; depression.
Chief Complaint: Severe neck pain (described by the patient as “very, very, very painful”), significant limitation in cervical motion, bilateral upper extremity radiating symptoms, headaches, dizziness, and impaired sleep. The patient also reported inability to comfortably rotate her head, pain behind the shoulders, occasional balance disturbances, and episodes of dizziness requiring support or sitting.
Past Interventions and Outcomes: Longstanding cervical dysfunction with limited improvement from previous therapy interventions.
Clinical Findings
Subjective
| Location | Pain Description | Pain Severity | Aggravating Factors | Alleviating Factors | Neck Disability Index |
| Cervical spine; bilateral shoulder region; bilateral upper extremities | Burning; dull/aching; stabbing; tender; numbness/tingling | Current: 10/10; Worst: 10/10; Average: 10/10 | Prolonged positioning; lying down; nighttime positioning | Heat; massage; medication | 31/50 — severe disability category |
Functional limitations: difficulty with sleeping, turning the head, maintaining comfortable posture, reading, work-related activities, and prolonged positioning.
Objective
Cervical active range of motion:
| Motion | Active ROM |
| Flexion | 35° |
| Extension | 40° |
| Right Rotation | 50° |
| Left Rotation | 55° |
| Side Bending Right | 5° |
| Side Bending Left | 5° |
Movement was limited by pain, muscle guarding, and severe cervical tension.
Strength deficits: significant weakness observed in cervical flexors, deep neck stabilizers, scalenes, and cervical rotators, with most cervical muscle groups testing between 2+ and 3-/5.
Mobility findings: significant mobility restrictions identified particularly at C2-C3, the upper cervical segments, the cervicothoracic junction, and upper rib articulations, alongside severe muscular guarding, increased cervical muscle tension, and restricted soft tissue mobility.
Detailed Treatment, Timeline, and Outcome
1. Timeline
Treatment proceeded across a course of cervical mobilization, soft tissue treatment, stretching, therapeutic exercise, postural retraining, and TECAR therapy, with manual therapy performed cautiously using low-grade mobilization techniques given the patient’s osteoporosis diagnosis. Specific session counts and dates were not specified in source documentation.
2. Diagnostic Assessment
Diagnostic methods: clinical interview and pain characterization, Neck Disability Index (NDI), cervical active range of motion testing, manual muscle testing of cervical musculature, and segmental mobility assessment.
Diagnosis: chronic cervical dysfunction (cervicalgia with possible cervical radiculopathy) characterized by severe muscle spasm, protective guarding, upper cervical hypomobility, impaired neuromuscular control, pain-related movement restriction, and radiating upper extremity symptoms. A major contributor to dysfunction appeared to be persistent cervical muscular hypertonicity and neuromuscular overprotection.
Prognostic characteristics: chronicity of the condition and comorbid osteoporosis, arthritis, anxiety, and depression were noted as factors requiring cautious, low-grade manual therapy progression.
Therapeutic Intervention
1. Type of Intervention
Manual therapy interventions included C2-C3 mobilization, occiput-C1 mobilization, side glide mobilization, flexion-extension mobilization, and soft tissue stretching of the SCM and scalene muscles, aimed at reducing cervical restriction, improving mobility, decreasing joint stiffness, and reducing protective muscular guarding. Given the patient’s osteoporosis diagnosis, these were performed cautiously using low-grade mobilization techniques.
2. Protocol Steps — TECAR Therapy
Although similar TECAR device settings can be used across different presentations, the therapeutic goals in this case were fundamentally different from a tissue-healing or progressive loading context. Here, TECAR therapy was primarily utilized for neuromuscular downregulation, muscle spasm reduction, relaxation of hypertonic cervical musculature, reduction of guarding, and facilitation of cervical mobility.
- A major component of this patient’s presentation involved persistent cervical muscle spasm and protective muscular contraction, with severe tension noted through the upper trapezius, SCM, scalenes, suboccipital region, and deep cervical musculature — significantly contributing to restricted cervical range of motion, pain during movement, compressive loading sensitivity, and reduced tolerance to prolonged positioning.
- TECAR therapy was utilized to decrease muscular hypertonicity, improve local circulation, reduce pain-mediated guarding, facilitate relaxation of cervical musculature, and improve soft tissue extensibility prior to mobilization. The thermal and neuromodulatory effects of TECAR were clinically valuable in reducing protective muscle spasm, improving tolerance to movement and manual therapy interventions.
- Integration with manual therapy: TECAR therapy was combined with cervical mobilization techniques to facilitate improved tissue relaxation, greater mobility tolerance, reduction in muscular resistance, and improved cervical movement quality — intended to reduce mechanical and neuromuscular restrictions limiting cervical motion.
3. Changes in Therapeutic Intervention
No specific parameter changes across sessions were documented; the combined TECAR plus manual therapy approach was maintained throughout, with manual techniques kept at low grades given the osteoporosis diagnosis.
Treatment Protocol and Follow-Ups
Session Frequency / Techniques: Cervical joint mobilization (C2-C3, occiput-C1, side glide, flexion-extension), soft tissue stretching of SCM and scalenes, therapeutic exercise, postural retraining, and TECAR therapy — frequency not specified in source documentation.
Clinician- and patient-assessed outcomes: Patient-reported neck comfort and mobility; therapist-observed cervical tension, movement fluidity, and tolerance to cervical motion.
Important follow-up diagnostic and other test results: Not specified beyond clinical response described below.
Intervention adherence and tolerability: Assessed via clinical observation; manual therapy performed cautiously due to osteoporosis with no reported adverse reactions.
Adverse and unanticipated events: None reported.
Results after Treatment Completed
Following treatment, the patient demonstrated visibly reduced cervical tension, improved neck relaxation, improved side-bending mobility, decreased stiffness, and improved comfort during movement. At follow-up, the patient reported significant improvement in neck comfort, improved mobility, and reduced sensitivity despite cold weather conditions that normally aggravated symptoms. The therapist additionally observed decreased muscular guarding, improved movement fluidity, and improved tolerance to cervical motion.
Discussion
This case highlights the important role persistent muscle spasm and guarding can play in chronic cervical dysfunction. In this case, TECAR therapy functioned primarily as a neuromuscular relaxation intervention, a muscle spasm reduction strategy, and a preparatory treatment for manual therapy and movement restoration.
The intervention appeared particularly beneficial in reducing cervical hypertonicity, improving tissue compliance, decreasing movement-related pain, and improving cervical mobility tolerance. Rather than functioning solely as a passive modality, TECAR therapy was integrated into a comprehensive rehabilitation strategy emphasizing mobility restoration, neuromuscular regulation, manual therapy, and active patient participation.
Limitations include the absence of repeat objective measures (NDI, ROM) at discharge, and the single-patient design with multiple comorbidities (osteoporosis, arthritis, anxiety, depression) that may have influenced both presentation and response to treatment. Take-away: a multimodal rehabilitation approach including manual therapy, cervical mobilization, stretching, therapeutic exercise, and Winback TECAR therapy was associated with meaningful improvements in cervical comfort, muscular tension, movement quality, and functional mobility — with TECAR specifically valuable for muscle spasm reduction, neuromuscular relaxation, reduction of protective guarding, and facilitation of cervical mobility and manual therapy interventions.
Patient Perspective
The patient described her neck pain prior to treatment as “very, very, very painful.” Following treatment, she reported significant improvement in neck comfort and mobility, and reduced sensitivity to symptom triggers (such as cold weather) that had previously aggravated her condition.
Informed Consent
Not specified in source documentation. Patient consent for use of de-identified clinical data in this case report should be obtained and documentation made available on request.