Effect of physiotherapy on pain associated with accessory nerve injury after thyroidectomy. Case report

ABSTRACT

BACKGROUND AND OBJECTIVES  Thyroid cancer is the most common cancer of the endocrine system. Depending on the histological type and size, total thyroidectomy with resection of recurrent lymph nodes is the most indicated intervention. In this type of surgical modality, the accessory nerve can be injured, resulting in paralysis of the trapezius muscle and consequently dropped shoulder syndrome, characterized mainly by local and radiating pain. This study reports the impact of the physiotherapeutic approach on pain associated with accessory nerve injury in a patient who underwent thyroidectomy.

CASE REPORT  A 37-year-old female patient, diagnosed with papillary thyroid carcinoma and cervical lymph node metastasis after a physical therapy assessment, underwent total thyroidectomy and neck dissection and, as a consequence to the procedure, had a lesion of the accessory nerve. She underwent physiotherapy to treat pain, increase range of motion and strength in the shoulder homolateral to the surgery. The physiotherapy treatment consisted of myofascial release, stretching and progressive resistance exercises, joint mobility and functional bandaging. The patient showed improvement in pain, range of motion and strength in the affected shoulder.

CONCLUSION  The combined application of stretching, progressive mobility and resistance exercises, myofascial release and application of functional taping proved to be a treatment that brought good results for the patient.

Keywords:
Accessory nerve diseases; Case Report; Head and neck neoplasms; Pain; Physical therapy modalities

HIGHLIGHTS

The role of physiotherapy in the treatment of pain associated with accessory nerve injury

The association between pain, accessory nerve damage and thyroidectomy

Pain dysfunctions associated with spinal nerve damage