there was a patient, a young lady working in BPO industry having recuurent neck pain. she was started on treatment after which she would become better but after some time she would come back with same complaints. After investigating in detail we found that her pain would precipitate when there was bumpy ride and she would be back from night shaift and siiting in rear seat. this led to conclusion that cab driver who is trying to be on schedule on bumpy roads is sometimes driving fast along with employee who is half sleep and unable to sit erect gets a jerk resulting in tissue injury which cuases pain neck radiating to arms and muscle spasm. i think we can term this as “BPO cab symdrome“. treatment in such cases would be sitting properly in cab and avoiding driving fast and bumpy roads if possible.