Conservative management of neck and thoracic pain in an adult with neurofibromatosis-1.

Objective: To describe the case of a 21-year-old female with previously diagnosed neurofibromatosis type 1 (NF1) with neck, scapular, lumbar, and temporomandibular discomfort along with headaches.

Clinical features: The patient had chronic tightness and pain in the cervicothoracic region as well as pain in the lumbar spine at the site of prior neurofibroma removal. Radiographs demonstrated multilevel osseous changes. In addition to NF-1, she was diagnosed with cervical myalgia, tension-type headaches, and chronic temporomandibular joint disorder.

Intervention and outcomes: Treatment consisted of a course of manual therapy including cervical flexiondistraction, myofascial release, patient education on workplace ergonomics, and an at-home active care plan. The patient experienced a reduction in pain and headache frequency.

Summary: Manual therapy in the form of cervical flexion-distraction with myofascial release and education on workplace ergonomics were effective in reducing neck and thoracic pain as well as reducing headache frequency in a 21-year-old with NF-1.