Date:12/24/12
Just a case update on the acute low back pain patient I wrote about last week:
The patient was initially seen on Wednesday and then followed up on Friday. Before her first intervention on Wednesday her lumbar spine pain level was a 7/10. Following intervention her pain level was a 0/10. She no longer had pain upon flexion. The day of the treatment she had multiple business meetings and was in and out of her car all day long without pain. She noticed some soreness in the low back that evening but continued with no pain upon flexion.
By Friday she had no muscle guarding to palpatory pressure over the L4-5-S1 paraspinal region. She stated she felt some discomfort in the low back rated a 3/10, however there was no pain on flexion or other movements. On examination there was no muscle guarding to palpatory pressure over the L4-5-S1 paraspinal levels. Previous hypomobility in the left and right upper sacroiliac joint was normal. Palpatory intersegmental hypomobility was present at L2-3-4. Lumbar flexion was full range without pain as were the other ranges. Treatment consisted of flexion distraction mobilzation L3-4-5 in flexion followed by 12 ATMs' in lumbar flexion.
As the patient was being stablized in the ATM2 during the set-up phase she commented on how good the stabilizing pressure belts over the pelvic region felt. She preferred bilateral compression with the belts without bias to one side over the other. The subjective 3/10 level discomfort she had pre-intervention was now 0/10. That evening she had an office holiday party to attend which she did so in high heel shoes and was able to enjoy dancing without pain. The following morning she had a 6 am flight to catch to spend the holiday break in New York.
In summary after her first treatment on Wednesday she was pain-free going from a 7/10 to 0/10. My instructions to her were to do some walking during the day but nothing strenuous. I certainly did not encourage her to get in and out of a car that day nor to dance in high heel shoes the evening of her second treatment. Yet, this patient, who could not arise out of a chair without moderatley severe pain on Wednesday, was able to get in and out of her vehicle several times that afternoon to attend business meetings, then attend an office holiday party on Friday night dancing in high heels and then catch a flight to NY the next morning without difficulty.
Frank Lanzisera, DC