Patient is a 33 year old Caregiver with Heavy job demands including Sustained Postures and Repetitive Movements currently reported to be on Lost Duty. Patient sustained an injury to her Neck/Cervical Region and R upper extremity on 5/04/15 when she was transferring a client from a wheel chair to bed and heard shoulder pop. DX: Cervical Disc Degeneration, Brachial Neuritis, and Sprain R Shoulder. Patient began this physical therapy on 6/08/15 and was last treated on 7/01/15 with a total of 8 visits completed. Currently patient reported to have high pain at 7/10 with strength and no ROM deficits also reported. Patient does have pain end range of motion. patient is reporting R arm numbness and reflexes on R are diminished compared to L. Progress note AROM from 6/08/15 compared to currently 7/01/15 is as follows: Cervical: Flexion 60d no change, Extension 65d with pain same, R SB 45d with pain same, LSB 50d same, B Rot 45d with pain on L same. Strength testing on R for Cervical spine is as follows: Bicep 3+/5 same, Deltoid 4-/5 same, Triceps 3+/5 same, Wrist extensors and flexors 2+/5 same and L grossly 5/5. Special testing positive for Spurlings, Distraction, Ulnar, Median, and Radial on R with Positive Spurlings only on L with no change since last progress note. Patient has made very small changes in hand strength. No issues are noted with compliance and barrier to meeting work related are noted to be arm numbness and strength loss. Patient has informed therapist that Neck surgery is a possibility. Treating Therapist is requesting treatment of 2 visits x 6 weeks at 60 minutes for treatment time. Spoke with Eric Bloom, PT who states patient was returning to physician to see if surgery was requested/authorized or if physician wants patient to coninue therapy in an attempt to avoid surgery. Therapy center is trying to contact patient at this time. Baed on possible surgery, and minimal gains from therapy reported by treating therapist, Eric Bloom, PT agreed to future care for 2 visits weekly x 2 and then 1 visit weekly x 1 at 60 minutes for treatment time. Further skilled physical therapy intervention is supported based on significant strength deficits and so patient can maximize ROM and strength for possible future surgery. Total visits currently authorized for 12 visits visits minutes and progress will be moniormonitored with possible surgery to be scheduled.