Douleur et Analgesie, 2026/01, 39(1):4–13. doi: 10.1684/dea.2026.0359, type of study: ,cr,,,,,

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Keywords:

cervicobrachial pain [1]
neck pain [180]
cervical pain [6]
osteopathic diagnosis [15]
osteopathic manipulative treatment [3946]
OMT [3925]
case report [736]

Abstract:

A 29-year-old woman with no previous medical history presented with chronic cervicobrachial pain associated with tension type headache. These disabling symptoms, resistant to initial treatment with anti-inflammatory drugs and physiotherapy, were having a major impact on her quality of life. Further investigations (X-rays, CT scan, MRI, electromyography) revealed no structural abnormality or underlying pathology to explain the persistence of pain. Referred to a hospital pain assessment and treatment service, she was managed by an osteopath using the Osteopathic Protocol in 2 Sessions (PO2S). Osteopathic examination identified a rare vertebral dysfunction of the seventh cervical vertebra (C7) in lateral glide, which is rarely described in the literature. Targeted manipulation of C7 in lateral glide, as part of PO2S, resulted in complete resolution of brachial pain after the first session, followed by complete resolution of pain after the second, with full recovery of function without recurrence. Although the pain was chronic, there was no evidence of associated nociplastic pain. This case illustrates the value of incorporating short, targeted osteopathic treatment into the decision-making algorithm for chronic neck pain associated with CBN type pain refractory to conventional treatment. Finally, it forms part of the ongoing validation of the PO2S study project, already supported by three exploratory studies, by demonstrating its potential in the treatment of persistent pain in the absence of an identifiable lesion. © JLE 2026