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 A male, 73 years old came with chief complaint difficulty turned his head
because of pain on right neck. Since one week ago, he complained pain on his right neck
especially for turning his head to the right. The pain arised if he turned his head to the
right and relief if he turned his head at the first position. The pain didn¶t feel until
shoulder or right arm. The pain didn¶t caused by heavy activities. He didn¶t complaint
stiffness neck or feel warm. He only used balsam for the pain but is not relief. The pain
felt same as the first time. He has hypertension since 4 years ago. He never had cervical
trauma. He is a pensioner of civil servant. He only do a slight activities such as
gardening. The patient may be arised spasm of his muscle on the neck that was concluded
on anamnesis which can make limit rotation and pain when he turned his neck. It most
frequently arised at older peoples. The pain was not with headache, radiculating or
located pain so we can exclude acut torticalis. The etiology of cervical pain in these
patient unknown because there was no history of trauma, infection and extraordinary
activities or sports on anamnesis.

On examination, there was a limitation on his range of motion (ROM). For

forward/backward flexion: 50/30, right/left flexion: 30/30, right/left rotation: 30/30. The
result for provocate test are negatives for Lhermitte test, Distraction test, Valsava test,
and also Nafzinger test. We could concluded that there was no abnormality on
examination of Range of Motion but the patient feel pain when did it.

The additional examination which has done include plain foto x-rays cervical
AP/Lateral and laboratorium examination include creatinin kinase. But when the case
report was made the result of plain foto has not finished yet so we could not conclude the
diagnosis and the etiology based on additional information.

From anamnesis and on examination we could conclude that the diagnosis was
cervical pain. The therapy of these patient was medical rehabilitation program include
Educate the patient and his family about patient diasese, Infra Red Radiation (IRR) on
cervical 3 times a week, occupational therapy: avoid tention and heavy things on cervical
sosiomedic: give motivation and counseling to hir family to always do the program.
psychologic: give motivation for the patient to maintain hir program.