Case of the Month April 2015

I have often said, both in the blog and office, that I have the best job on earth.

Recently I had a patient in the office that was hurting. Not only was their low back hurting, he looked like a pretzel as he was all twisted up.

After a thorough history and examination, I determined that he had a significant structural shift that was causing a whole host of secondary conditions. While the low back pain and leg pain were bothering him, it was the problem moving his bowels that was bothering him the most.

After the patient’s first visit, he walked out a little straighter than the when he walked in. While there was not an immediate decrease in pain, not unexpected, the patient was moving a little better.

The cool part is what happened two hours later.

The patient reported he had a bowel movement that, well let’s not get too graphic here, was slightly bigger than usual.

The bodies ability to heal itself never ceases to amaze me.

If we get the structure lined up and allow the body to do what it knows how to do, amazing things can and do happen.

 

I Threw My Back Out Tying My Shoe!

Sadly, most people that come to see me for the first time show up with some form of pain. Low back, sciatica, neck pain, shoulder pain, etc…

I say sadly because here is a little secret for you…it doesn’t need to be that way.

We tend to be a nation of reactors instead of proactors … if that makes any sense!

Please allow me to explain.

When someone tells me they through their back out tying their shoe, they are often incredulous that something so routine could be causing them this much pain. As I listen, I smile, nod, empathize and then with varying degrees of success, attempt to explain to them that the act of tying their shoe really wasn’t what threw their back out.

When we do something as innocuous as tying our shoe and our back goes out; causing extreme pain, the act of tying the shoe was simply the final straw.

In the absence of trauma, it is almost never the final act that causes the pain that you are feeling. The pain is usually something that has been building up for some time. How we are sitting, sleeping, the stress we are under and even the food we are or are not eating all goes into the pot. What comes out the other side of that is often a stressed out body and brain that has little room for error.

Hence, the simple act of bending over to tie one’s shoe throws your back out and causes you we wear nothing but Crocs for the rest of your days, and that is the real tragedy!

As I tell people in my office, it is much easier to stay ahead of things than to always be catching up to them. Please pay attention to the little things like taking a break from the computer, drinking plenty of water, and even exercising a little bit everyday.

If you follow my advice, the next time you come in my office it will be for a checkup and not because you threw your back out getting the water from the fridge!

 

 

Fantastic Video by CBS News

Anyone who has known me for any period of time will probably agree that I think I am pretty good at what I do.

Well now, CBS News agrees also!  They may not mention me by name but you all know they are really talking about me!!!

Please note when they talk about the best way to stay out of back pain.

Case of the Month July 2010

Illustration of the pain pathway in René Desca...
Image via Wikipedia

A patient, that we will call Ben, reported to my office with low back pain that was traveling down his right leg all the way to the foot.  Upon exam it was pretty clear to me that Ben had a pretty tough case of sciatica, and trust me when I tell this, sciatica is no fun.

Let’s do a quick anatomy review.  The sciatic nerve begins in the low back, right around the top of your hips, or what you will hear as L4 and L5.  This nerve runs through the buttocks and continues down the leg.  When a person has sciatica, pressure is placed on the nerve somewhere along the path and the result is usually pain, although numbness can also be present.

Back to Ben.  When asked to rate the pain on a scale of 1 to 10, with 10 being miserable, Ben was a 9, which indicates it was quite severe.  Upon exam, Ben was showing tight musculature in the low back, decreased movement in the low back and tight musculature in the right buttocks.  Ben’s posture was a mess and several tests revealed the sciatic nerve was aggravated, to say the least.  X-ray was unremarkable.

I suggested to Ben that we try a short trial to make sure that this was the right course of action for him.  He agreed and we began with chiropractic adjustments, exercise, trigger point therapy and traction.  Ice was also applied after each visit.

At first we made some crazy improvements.  Ben’s pain rating dropped from 9 to 5 after 3 visits.  That gave us some information that this was the right course of action and not necessarily a disc herniation as can often be the case with leg pain cases.

The going after that was much slower.  Over the course of 3.5 weeks, we have been able to get Ben’s pain down from a 5 to a 2.  Ben is thrilled with his progress, me I am a little impatient.

In the coming weeks we are looking to improve Ben’s pain to a zero, while helping him with strength and conditioning to increase the chances that this doesn’t happen again.

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Glucosamine

Have you been taking Glucosamine for chronic low back pain?  A recent study has shown that this may not help when compared to a sugar pill, better known as a placebo.

I had no idea that more than 25% of people with chronic low back pain had tried Glucosamine at one point.

The article does mention some things that may help one with low back pain.  One of them is cognitive therapy…hmmm I wonder what they mean by that?  Are they trying to say the brain may contribute to chronic pain?

This is something that chiropractors have been preaching for a very long time.

You can read the article here.

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