Management of Early Cervical Disc Desiccation Wıth Severe Hypoplasia in Young Female wıth Pilates Exercise – A Case Report

Abstract

The purpose of this case report is to systematically document the physiotherapeutic management and clinical outcomes of a 22-year-old woman diagnosed with early cervical disc desiccation with concurrent left transverse sinus hypoplasia. This report seeks to elucidate the role of structured physiotherapy in addressing persistent neck pain, postural deviation, and the associated biomechanical alterations, thereby contributing to the clinical understanding and rehabilitation strategies for premature cervical disc degeneration. A detailed examination showed trigger points, positive neural provocation indications, muscle weakness (MMT 3/5), and decreased cervical range of motion. Multilevel disc desiccation with loss of cervical lordosis was confirmed by MRI, and left transverse sinus hypoplasia was seen on the MR venogram. Using Pilates-based exercises, myofascial release, cervical mobilisation (Maitland), stretching, TENS, ultrasound therapy, and manual traction, a four-week multimodal physiotherapy intervention was administered. From passive methods to active neuromuscular re-education, the sessions progressed. Significant clinical changes were seen after the intervention: muscular strength increased to MMT 4/5, cervical range of motion improved in all directions (e.g., flexion from 30° to 55°), and pain intensity on the NPRS dropped from 9 to 2. In addition, the patient reported better posture and functional mobility, less frequent headaches, less upper back pain. A structured, multimodal physiotherapy approach has been effective in treating early cervical disc desiccation in a young patient, as observed in this case study. When Pilates was combined with stretching, manual treatment, and electrotherapy, discomfort and functional restrictions were decreased.