Who:

52 year old female equestrian who was referred in by her husband.

Symptoms:

Severe unrelenting pain in the lower back on the right side. See pain diagram below.

This came about when she felt a popping sensation in her low back when she was putting something in her car.

This was not the first time she had back pain.  She said she has had on and off back pain for at least two years in the same exact area, just not this extreme.

She has not been riding on her horse because of the pain, which she dearly misses.

These things made it worse:

1. Sitting more than just a minute or two.

2. Sitting to standing

3. Getting out of bed

4. bending

5. laying on her back

Previous treatment:

1. Aleve pills  (4-6 per day)

2. Hydrocodone (1 a day)

3. Rest and ice

Chiropractic/orthopedic examinations:

1. Three (3) disc tests made her pain worse, including the cough test.

2. Flexion and extension (forward and backward movements caused more pain).

X-Ray studies:

Severely degenerated disc at L5-S1. See her x-ray below.

Treatment: 

I treated her with computerized chiropractic adjustments.  I set the force on the instrument to 400 Newtons (equivalent to 88 pounds of force).  This is the optimum setting for the lumbar spine (low back).  It turned out to be a very comfortable setting for her. Had it not been, I simply  would have  lowered it down.

Outcome:

After just a few days of the computerized chiropractic adjustments her back was letting up where she could bend and twist again.  After another week, she was completely off the medicine. At her 4 week re-evaluation, she said all her pain was gone. Only on a few occasions, two days earlier, had she noticed the pain when she bent forward.

At that point, I gave her cross crawl exercises and told her she could start riding again at a easy pace without the jumping.

Because of the amount of disc loss, I advised her it would be wise to have periodic computerized chiropractic adjustments in order to decompress the area to keep the joint (the last spinal bone-L5) moving, to eliminate more degeneration.

Comments:

I really enjoyed this case because for one, it was easy to find the cause; a worn out disc, with a probable disc bulge.  The other reason I enjoyed it so much, was that she responded fast to the computerized chiropractor adjustments.  The setting on the instrument (400 N) worked well, so when I maintain her spine, I know the exact amount of force she needs in her spine to keep it healthy.  This force cannot be replicated with manual chiropractor adjustments, which is another reason I am so fond of computerized chiropractic adjustments.

As a side note, the condition her disc was in, was probably from some type of trauma she had in her life about 20-40 years ago.  The body has a way of adapting. The symptoms of a disc that is degenerating may not even show up for 20 or 30 years later, which was in her case.  I remember my uncle’s heart problem first showed up at 62 years of age, they found that his arteries had been all clogged up.  His first symptom though, unfortunately was fatal.

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Self -Employed Louisville man can barely work because back pain is so debilitating. 10 out of 10 on pain scale.

Dr. Graham, a Louisville, Chiropractor, utilizes computerized chiropractic adjustments to correct problem

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Who:

45 year old business man consulted with our chiropractic office for severe low back pain, that he describes as a 10 out of 10.

Past care:

OTC: Advil 6-10 a day.

Symptoms:

Severe unrelenting pain in the middle of his lower back with pains radiating into the front of both thighs.

He was not aware of what brought this on, but revealed that he has had similar pains, although not nearly as painful or relenting as this is now, in the exact area for the last 2 years. He has been previously diagnosed with a ruptured disc at he L4-L5 level from an MRI.

These things made it worse:

1. Bending
2. Lifting
3. Sitting
4. Standing
5. Walking

Chiropractic/orthopedic examinations:

1. Four (4) disc tests made his pain worse, including the cough test and straight leg
raise
2. Bending forward and backwards was very limited and caused him great discomfort
.

X-Ray studies:

The side view of his lumbar spine was degenerated at multiple levels. See his x-ray below.

Note the degeneration, especially at L1-L2  and L3-L4.

Working Diagnosis:

1. Degenerative discs L1-L5
2. Bulging disc at L3-L5-S1
3. Lumbar spinal stenosis

Treatment:

I treated him with computerized chiropractic adjustments. I set the force on the instrument to 400 Newtons (equivalent to 88 pounds of force). This is the optimum setting for the lumbar spine (back).

Outcome:

After 10 days of the computerized chiropractic adjustments he was at a 4 out of 10 on the pain scale. He still had pain down the legs.

After 30 days 80 % of his leg pain was gone.

After 60 days 80% of his back pain was gone and he still had anout 15% of his leg pains.

The 90 day examination revealed 90 % of his back and leg pain had left. He was doing well at work and getting through long days.

Comments:

This was an unusual case as I am not used to seeing that much degeneration on a 45 year old man. I honestly did not think he would respond this well because of the lack of disc space and the arthritis that had set in.

This is yet another case where I had to be careful not to treat the x-ray. If I had done that I may have sent him for an MRI. This necessarily may not have been a bad thing, but I pretty much knew what we would find.

Many times people do very well even though they have what looks like a very bad x-ray or MRI. I am careful to refer these patients out, because many times the surgeon will look at the film and say it is a 7 mm bulge and it should be cut. However, I have seen plenty of these on MRI who responded well our computerized chiropractic adjustments and never had surgery. These people are still doing well after five years.

This is an example of this. This patient has been receiving chiropractic computerized  adjustments 2 times a month to keep the spinal bones moving to prevent inflammation and increase blood flow to the intervertebral discs.  This program of chiropractic adjustments has kept his back and leg pain away for the most part.  as a side note has he not had to take even over-the -counter type drugs. in the long run this could potentially save his colon from bleeding stomach ulcers.

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Ford worker  was taking 10 Advil a day to battle a low back problem and trying to work at the same time.

Dr. Graham, a Louisville, Chiropractor, utilizes computerized chiropractic adjustments to correct problem

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Who:

47 year old male who is employed at the Ford Motor Company, consulted with our chiropractic office for low back and leg pain.  He was referred to our office by his friend.

Past care:

OTC: Advil 8-10 per day

Symptoms:

Moderate to sometimes severe pain in his middle lower back, that he stated was there to some degree, all the time. The pain radiated into both of his thighs to the back of his knees (see diagram).

He believes that he injured it 4 years ago when he was forced to change his gait after he hurt his knee.

It had been getting worse 3 months ago.  He reported to me that he thought it was going to go away on its own 3.5 years ago.  And when it just kept getting worse, three months ago, his friend referred him to our office.

To help to relieve the pain he did the following:

1. Advil pills  (8-10 per day)

2. Hot showers and heat

These things made it worse:

1. Sitting (15 minutes)

2. Standing (5)

3. Walking (10)

4. Bending

5. Laying on his stomach

6. Sneezing and coughing

Chiropractic/orthopedic examinations:

1. Four (4) disc tests made his pain worse, including the cough test.

2. Two (2) sacroiliac (pelvis) tests made the pain worse

3. Two (2) spinal facet (rear spinal joints) tests were positive.

4. Bending forward (flexion); backwards (extension) and bending to the right, all

   caused severe pain. Turning (rotation) to the right caused moderate pain

X-Ray studies:

The front view of his low back reveals a misalignment in the lowest part of the lumbar spine, L5. See his x-ray below.

Working Diagnosis:

1. Bulging disc at L5-S1

2. Probable beginnings of degenerative disc at L5-S1

3. Misalignment at L5

4. Sacro-iliac joint fixation (pelvis jammed up with the sacrum)

Treatment:

I treated his lumbar spine and sacro-iliac joint (low back and pelvis) with computerized chiropractic adjustments.  I set the force on the instrument to 400 Newtons (equivalent to 88 pounds of force).  This is the optimum setting for the lumbar spine and pelvis.

Outcome:

After 5 days of the computerized chiropractic adjustments his thigh pain was 40% improved.

30 day examination: low back pain 50% improvement; thigh pain 70% improvement.

60 day examination: low back pain 80% improvement; thigh pain 90% improvement.

90 day examination: low back pain 95% improvement; thigh pain 95% improvement.

Set him up for periodic computerized chiropractic adjustments set at 400 N,  two times a month to improve the following:

1. posture

2. improve nutrition to disc to avoid accelerated degenerative changes.

3. keep sacro-iliac joint un-jammed.

4. improve movement to the L5-S1 joint

In addition, he needs to do the following:

1. Prescribed specific home exercise for his low back

2. Attend in -house class on posture and stress each quarter (4 times per year)

Comments:

This was a fun case for me because this was not as complicated as some and I anticipated fairly fast results, because his degeneration in his lumbar spine was at a minimum.

Although he had positive disc signs they were not as pronounced as some I have seen. That made me think his bulges were small ones at best (1-3mm).  His bigger problem turned out to be his pelvis and sacrum (most bottom part of the spine and below the lumbar spine).  Both sides were stuck, jammed or fixated.  This is very prevalent, especially with men because of past slips and fall, sports, etc.

These problems sometimes can also mimic a sciatic nerve problems to some extent.  The other area that showed up was a misalignment of the lower lumbar spine (L5).  These misalignments are not the issue as much as spinal bones that are adhering together, like his sacro-iliac joints were.  So just looking at an x-ray and seeing that the spine is straight or misaligned is not good doctoring because until you dynamically test it, you can easily mis-diagnose a problem.  This is why the doctor cannot treat an x-ray. He has to treat the patient.

This gentlemen did very well. However, he does have a disc that is wearing, he has a pelvis with a propensity to jam, which can lead to accelerated wear and tear of the last disc in his back (L5-S1).

Bi-monthly adjustments will keep his lumbar spine and pelvis unjammed and help him get off the fast track to serious permanent damage to the disc and spinal bones.  All that Advil he was taking was a bleeding stomach ulcer waiting to happen. He should thank his friend who referred him.

As a final note, part of the care is a quarterly in house class on posture and stress. This covers how the spine and nervous system can microscopically break down each time we make a poor choice in how we sit, stand and lay down. Every decision we make has a consequence.

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49 year old physical laborer is healed of 3 year leg pain.

Dr. Graham, a Louisville, Chiropractor, utilizes computerized chiropractic adjustments to correct problem

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Who:

49 year old male who is a physical laborer consulted with our chiropractic center because of moderate to severe back and leg pain. He is a tall and stout man who reported to me that these pains have been present since 2010 (3 years). He believes hard labor for many years had lead to his problem.

Past care:

Medical: past doctor visits resulting in various prescription medicines.

OTC: Ibuprofen (3 day), heat, ice, aspir-creams

Symptoms:

He describes the pain as going in the middle of his lower back and then it radiated down his left glute, back of his thigh, calf, ankle and his whole foot.

He described the leg pain as throbbing.

These things made it worse:

1. Sitting for more than 5 minutes (needed to stand up)

2. Bending

3. Sneezing and coughing caused pain to shoot down the leg

4. Laying down hurt in any position

Chiropractic/orthopedic examinations:

1. Two (3) disc tests made his pain worse, including the cough test.

2. Exhibited positive pelvic tests (2)

2. Bending forward caused severe pain as did rotating (twisting) to the left

X-Ray studies: (see below)

1. Degenerated disc  L5-S1 (Phase 2 of 4)

2. Sharply angulated lumbo-sacral angle 61 degrees (37-41 is normal)

3. Right leg length deficiency (1/2 inch)

 

Working Diagnosis:

1. Bulging disc at L5-S1

2. Degenerative disc L5-S1

Treatment:

I treated him with computerized chiropractic adjustments.  I set the force on the instrument to 400 Newtons (equivalent to 88 pounds of force).  This is the optimum setting for the lumbar spine (lower back).

I considered at MRI if the patient did not respond after 30 days.

Outcome:

After 6 of the computerized chiropractic adjustments his leg pain was about 50% less at the 30 day re-examination, it was reduced 70%. At that point I gave him the cross-crawl exercises.

 The second re-examination at the 60 day mark, he reported 85% of his pain is gone. He said he could tie his shoes again in a normal way and could cross his left leg.  He can also sit for more than 2 hours before he feels any more discomfort.

 I scheduled his chiropractic adjustments to 2 times a month for 90 days. He is now getting computerized adjustments to his lower lumbar spine one time a month.

Comments:

This person has been a model a patient, he did not miss any appointments and healed faster than i expected with the condition he came in with.

He weighs about 300 pounds and these types of builds typically present more challenges because of the additional stresses on the disc and bone.

This is a great case also in that i believe the exercise i prescribed him really helped the speed of healing along.  i find that most of the patients don’t do as well when it comes to doing exercises. one of the reasons I like the cross-crawl exercise so much is because it is  probably the very best exercise in terms of how easy it is to do, how long it takes and the benefit it gives. This is the perfect exercise for that reason.

The degeneration of the disc is what causes the jelly substance to slip back (slipped disc).  Therefore, it is very important to keep a god blood supply to the disc so that it will not continue to die off and cause a bigger herniation.  If they get too big, often times it leads to having back surgery.  The best ways to keep the disc nourished and hydrated is specific decompressive adjustments to the spine (computerized 400 N of force), aerobic activity, lots of water.  All these things will prolong the life of a disc.