26B. Effect of Gua Sha and Physical Therapy on Fear Avoidance Belief Questionnaire Scores in a Patient With Chronic Cervicalgia

Focus Areas: Integrative Approaches to Care, Mental Health, Alleviating Pain BACKGROUND AND PURPOSE: Current musculoskeletal interventions for neck pain that do not address a person's fear avoidance beliefs about work and physical activity may have poor long-term outcomes. Research indicates a strong correlation between a person's score on the Fear Avoidance Beliefs Questionnaire (FABQ) and risk of chronic neck and back pain. Gua sha, a traditional Chinese medical intervention that uses repeated instrument-assisted brush stroking, may have a positive effect on connective tissue dysfunction and fear avoidance beliefs. The psychogenic benefits of gua sha may be secondary to the expression of petechiae, which in traditional Chinese medicine is associated with sha stasis. Raising sha may improve Qi circulation and decrease symptoms of anxiety and depression. The purpose of this case is to describe the combined interventions of physical therapy and gua sha to assist a patient in resolving her symptoms of chronic cervcialgia. CASE DESCRIPTION: The patient was a 56-year-old female with chronic cervical neck pain that was exacerbated with prolonged sitting in front of a computer, a requirement for her job. She presented to physical therapy after 3 years of chronic cervicalgia and several therapeutic interventions that did not provide any lasting relief. Her initial scores on the FABQ indicated high fear avoidance beliefs in relation to work and physical activity. INTERVENTION/OUTCOME: Patient received 2 weeks of physical therapy with minimal improvements in symptoms. Following 2 treatments of gua sha in conjunction with physical therapy, the patient had significant improvements in FABQ, Neck Disability Index, AROM, and pain scores. At 3-month follow-up, the patient was able to work full-time with minimal to no pain. DISCUSSION: These preliminary findings may suggest that gua sha in conjunction with physical therapy may benefit a patient on physical and psychological levels.