1643 - From Spa Days to Spine Woes: A Presentation of Atypical Severe Radiculopathy

77-year-old female presented to pain clinic complaining of left arm weakness without sensation changes that had started acutely 6 weeks prior following a deep tissue massage. Physical exam demonstrated 0/5 strength in shoulder abduction, 2/5 in both elbow extension and elbow flexion. MRI ordered showing extruded disc at C4-C5 and C5-C6. EMG demonstrated severe C5 radiculopathy. Patient was urgently referred to neurosurgery, who she presented to 3 months later and she received a partial corpectomy of C4, C5 and C6 with placement of structural interbody allograft with locally harvested autograft and anterior instrumentation. We present an abnormal case of severe C5 cervical radiculopathy following a presumed safe deep tissue massage. 


Discussions:

Acute, traumatic C5 traumatic radiculopathy is most commonly caused from sports injuries or motor vehicle accidents. This case presents an unusual cause of an acute, traumatic radiculopathy secondary to a deep tissue massage confirmed by EMG and MRI. Common modalities such as ice, heat and massage are often thought of as conservative without harm to help those with cervical myofascial pain. Physicians should exercise caution with recommending conservative modalities that involve manipulation or massage in patients with neck pain, particularly before obtaining imaging. From our research, this may be the first report of an acute traumatic radiculopathy following a deep tissue massage.


Conclusions:

Physicians should exercise caution with recommendations of deep tissue massage and other conservative treatments in the setting of neck pain, as there is the potential to cause harm.