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Chiropractic Journal of Australia : CJA June 2013
Chiropractic Journal of Australia Volume 43 Number 2 June 2013 75 Introduction Overcompensated Cervical Syndrome (OCS) is a condition first described by J. Clay Thompson, developer of the Thompson Technique, a chiropractic system of adjusting that utilises drop-piece tables.1 Thompson noted that when ABSTRACT: Introduction: This paper describes the identifcation and management of Overcompensated Cervical Syndrome (OCS) in 2 patients presenting to a chiropractic teaching facility. OCS was frst described by Thompson, developer of the Thompson Technique, and is characterized by neck pain and hypomobility, taut and tender trapezius, tender 1st rib, and spinous rotation of C2-C7. Clinical Features: Case #1: A 22-year- old woman presented with neck pain and stiffness, headaches and disturbed sleep following a motor vehicle accident. Examination revealed the presence of the indicators of OCS. Five adjustments were delivered over 9 weeks, and the patient reported complete resolution of initial symptoms. Case #2: A 36-year-old woman presented with neck and mid-back pain and headaches. Examination also revealed the presence of the in- dicators of OCS. After 11 adjustments over 12 weeks, her mid-back pain persisted, however OCS signs and symptoms resolved completely. Discussion: This case series illustrates the management of 2 patients present- ing with neck pain and other signs and symptoms of what Thompson described as OCS. Despite being frst outlined nearly 30 years ago, no account of it exists in the peer-reviewed literature. Practical experience has shown that OCS often follows an injury to the neck, such as an MVA (Motor Vehicle Accident), and may be diagnosed as cervical dystonia or torticollis. Since Thompson theorized that adjusting the 1st rib would alleviate the signs and symptoms of OCS, it is speculated that this adjustment normalizes neuromechanical dysfunc- tion of cervical musculature, particularly the trapezius. Summary: This retrospective case series describes the management of 2 cases of OCS using Thompson Technique chiropractic adjustments. Caution is urged when drawing defnitive conclusions from these results or when generalizing to other patients. Overcompensated Cervical Syndrome (O.C.S.): Two Case Reports Supporting the Thompson Technique Protocol RONALD WELLS, HAROLD BRINKLEY and ANNE M JENSEN Ronald Wells, BS, BS, DC, CCN, FASA Professor of Academics Department of Chiropractic Techniques and Philosophy Parker University, Dallas, Texas, USA Harold Brinkley, AA, BS, DC Clinic Faculty Doctor Parker Chiropractic Wellness Clinics Parker University, Dallas, Texas, USA Anne M. Jensen, DC, ICSSD, MSc, MSc, MACC Senior Researcher / Assistant Professor, Parker Research Institute DPhil Candidate, University of Oxford Parker University, Dallas, Texas, USA Departments of Primary Care and Department of Continuing Professional Development, University of Oxford, UK Manuscript received 21 April 2013, accepted 6 May 2013 No external funding was received in the preparation of this manuscript. The authors report no possible confict of interest, fnancial or otherwise, related directly or indirectly to the article. Index Terms: CHIROPRACTIC; CERVICAL DYSTONIA; TORTICOLLIS; PAIN, NECK; ALTERNATIVE THERAPIES; COMPLEMENTARY MEDICINE; MANIPuLATION, CHIROPRACTIC. Chiropr J Aust 2013;43: 75-9. patients presented with non-resolving or recurring neck pain, there was often multiple spinous process (SP) deviation toward the painful side with an associated ipsilateral taut and tender trapezius muscle.1 On the cervical anteroposterior (AP) radiographs of these patients, Thompson noticed a marked deviation of the C2-7 SPs, with progressively diminishing deviation from C3 to C7.1,2 Thompson described OCS as a global fxation usually induced by some kind of a trauma, such as a cervical acceleration-deceleration injury from a MVA.1,2 Hyman proposed that a T1 rib subluxation contralateral to the spinous process laterality caused a contracture in the upper trapezius muscle.2 He also proposed "The overcompensation of the cervical spine has occurred as a result of disturbance in the neurological control (ipsilateral and contralateral fbers), from the brain cell to the tissue cell (trapezius muscle)."2 In cases of OCS, Thompson1 suggests the correction involves checking for a contralateral frst rib subluxation, and after correction, a reduction of trapezius tension and tenderness is often noted immediately. See Figure 1 for a summary of OCS signs and symptoms. Neck pain is extremely common following a MVA, with over 60% of MVA victims reporting neck pain within days of the accident,3-6 and approximately half reporting continued discomfort after 1-2 years.6,7 It is clear that left untreated,
CJA March 2013
CJA September 2013