Who: 50 year owner of automotive shop consulted our office for chiropractic care. Previous Doctors: PCP put him on drugs. Symptoms: severe pain in left low back, left gluteal, and back of thigh, numbness to toes. 4-5 years of pain and getting worse. Worse: Standing and walking. 5-10 minutes before he needs to sit down. Chiropractic Examination: Revealed stress on his L4-L5 nerve root. This is the nerve that runs down the back of the leg. Makes up a portion of the sciatic nerve (see below). X-Rays: Revealed a Spondylolisthesis Grade II. See Wikipedia.Severe disc degeneration. Comments: I set him up for a neurosurgical consultation because there appeared to be so much spinal cord tension. I thought he might be a surgical candidate. The neurosurgeon agreed with me that it was very stable. So I began treatment. Chiropractic adjustments. I decided to use my computerized chiropractor adjustment instrument because it is so precise. Outcome: Within 2 weeks all of his leg pain was gone and most of his back pain. 5 weeks all of his pain left. Future: This type of spine requires ongoing treatment because the disc is severely degenerated. The chiropractic computerized adjusting works very well with alleviating pain and in slowing down degeneration. __________________________________________________________________________________________________________________________________

Victoria Secret employee has hard time standing at work because of back, leg and groin pains.

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

Who:

A middle aged, part time worker at Victoria Secret, consulted with our chiropractic office for low back, gluteal and leg pain.  She was referred to our office by her son.

Symptoms:

Moderate to sometimes severe pain in her right lower back, that she reported is present to some degree 75% of the day. She also noted that the pain radiated to her right gluteal, and down her leg to her ankle. She also had groin pain on the same side.(See diagram below)

This pain has been present for approximately 3 months, but it has in the past has bothered her off and on for the better part of 20 years.  However, the past 90 days it has felt quite a bit worse, especially while she is at work on her feet.

To help to relieve the pain she did the following:

1. Aspirin

2. Tylenol

3. Ibuprofen

4. Hot showers

5. Heating pads

These things made it worse:

1. Standing

2. Walking

Chiropractic/orthopedic examinations:

1. Two (2) disc tests made her pain worse

2. One (1) sacroiliac (pelvis) test made the pain worse

3. One (1) spinal facet (rear spinal joints) tests were positive.

4. Bending  backwards (extension);bending to the right and left all

   caused  pain.

X-Ray studies:

The front view of her low back reveals a misalignment in the lowest part of the lumbar spine, L5. Also noted in the same view is worn cartilage in her right hip joint. Notice the worn disc below. See Wikipedia.  See her x-ray below.See a similar x-ray of this type of misalignment.

Working Diagnosis:

1. Lower lumbar joint dysfunction L5-S1

2. Degenerative disc at L5-S1

3. Misalignment at L5

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

5. Right hip joint osteoarthritis and degeneration

Treatment:

I treated her 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.

I referred her for an orthopedic consultation for her right hip joint.

Outcome:

First week:  her gluteal pain was reduced 25%; could stand longer periods.

30 day examination: back, gluteal and leg pain reduced in excess of 50%. Can stand 75% longer at work.

60 day examination: back, gluteal and leg pain reduced in excess of  90%. Can stand 90% longer at work. Walking almost normal (groin pains 20%).


Set her 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, she 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 an interesting case in that it involved 3 separate areas of her spinal column.  1. Sacro-Iliac Joint. First and foremost, her sacro-iliac joint was very dysfunctional on the right side.  This could have been caused from old postural habits, i.e., sitting more on the right side than the left side. I believe that this was where the majority of her problems stemmed from (75%).

2. Lower lumbar spine.  Her lower lumbar spine was also stuck and had abnormal joint play.  I believe that this was a contributor, but the main issue. However, because there was noticeable wear and tear the adjustments may have warded off a problem that would have come on later.

3. Hip joint.  When a patient mentions growing pain especially with walking and standing, my antennas go up.  I am thinking that they may have a degenerated hip socket.  This was her case.  I believe it was a large contributor along with the sacro-iliac joint.

I immediately got her a consultation with an orthopedic surgeon to evaluate her hip joint.  The surgeon felt as though her hip joint was not in danger of needing a replacement.  He told her she would know when that time would be there, based on her pain levels.

She responded well to our computerized adjustments.  I explained that her body has a memory pattern and it will want to do what it has done for the last twenty years.  So it would be important to stay current with the things that helped her get over these pains. Specifically:

1. Adjustments to the areas to prolong the life of the discs and joints.

2. Exercise to keep blood moving, especially an aerobic types

3. Couple mile walks.  Half hour of walking has many benefits, one of which is it is very healthy for the back!

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Indiana man suffered with  2 years of back pain and numbness down left leg.

Dr. Graham, a Louisville chiropractor, corrects two year problem with computerized chiropractic adjustments 

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Who: 45 year old male consults Dr. Graham for chiropractic care.

Symptoms:  pain in the lower back on both sides that has been on and off for the last two years, the last couple months being worse.  He also has numbness down  the left leg.

Worse with:

                      1. standing more than one minute.

                      2. Sitting to standing

                      3. sitting for more than a half hour.

                      4. bending

                      5. laying on his back and stomach

Previous treatment:

Taking 6 Aleve pills per day

He has consulted with his family doctor and chiropractors in the past.

 Chiropractic/orthopedic examinations:

1. All the sacro-iliac tests were positive

2.Two disc tests affected sciatic nerve. See Wikipedia.

3. Flexion and extension (forward and backward movements) were very painful

X-Ray studies: .

Treatment:

 I treated him with computerized chiropractor adjustments.  These worked well with him.  He liked that better than the manual chiropractic adjustments because it was more comfortable and it worked better than the way he had been adjusted before.

I also advised him that if the pain did not start leaving pretty quickly we may want to consider a heal lift to help offset the difference in hip heights.  7/16″.  I don’t like to give those out to routinely because it is lifetime thing.

Outcome:

after 4 weeks we did a re-evaluation and he said he felt 75% better.  He could navigate around work most of the day with only having to sit a few times (before it was dozens of times).  The next re-exam we did 4 weeks later and he was 95% better.  There are days that his back did  not hurt at all, even after a long day at work.

We talked about maintaining the spine in order to keep the disc healthy.  Once the disc starts to degenerate they need to be taken care in some form or fashion, i.,e. chiropractic care, exercise, yoga, etc., or the disc can bulge out further and leads to a herniation.

Comments:

 This was an interesting case because both his lumbar spine (lower back) and his sacroiliac joints (pelvis) were compressed and restricted.  This caused the mechanical movement of his pelvis and back to be altered.

This was particularly difficult for him because he worked on his feet most of the day.

After listening to him in the consultation I was thinking it was probably a pelvis problem mainly because standing hurt him so much.  However, as we moved along into the examination, I found that the bottom disc in his back was probably bulging and degenerated (we had no MRI to confirm this, but sometimes a simple test can give you the information you need without running a $1,500 test).

I worked primarily on both sacroiliac joints ( see x-ray film for location) and L4-L5-S1 which did the job.  As a side note,  I find that probably as much as 60% of my cases are sacroiliac joint problems rather than lumbar problems. As a whole, I believe pelvis problems are often times mistaken as lumbar problems.

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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.

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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.