Case Study 1: Karen’s Chronic Back Pain
Description: Karen is a 49 year old Medical Doctor who has been dealing with low back pain for years. Having seen inconsistent results with her own patients with the traditional medical model, she was seeking an alternate plan.
Symptoms: Karen’s longstanding back pain started with a slip and fall down a small staircase at home over ten years ago. She has been dealing with on and off flare ups that are becoming more frequent and longer lasting.
Diagnosis: Chronic lumbar discogenic pain (typically due to degeneration, or wearing out, of the lumber intervertebral discs) with accompanying facet arthrosis (deterioration of spine joint cartilage).
Treatment Plan: Karen’s condition was treated in our three phase approach:
- Phase 1: Protection – Protecting Karen’s back from the activities or loads that were compromising her ability to heal. Since impimenting EHR (Electronic health records), Karen was sitting on average 8 hours a week more than before.
- Phase 2: Rehab – Karen had developed weakness in the hip muscles which was causing additional stress to the SI Joint and bursa. Thus, a Lumbopelvic stability program started focusing on core strength and stability.
- Phase 3: Self Care – A McKenzie approach to self management was our focus for positional symptoms, and a core strengthening program for maintaining relief.
Results: Karen’s symptoms were brought under control within 2 weeks. She now manages her pain with the protective measures we recommended and a modified work station.
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Case Study 2: Everyday Athlete – Crossfitter
Description of patient: David is a 36 year old systems engineer and crossfitter dealing with 2 weeks of back pain.
Symptoms: Acute low back pain intensified by cross fit workouts and prolonged bouts of sitting.
Diagnosis: Acute annular tear of the lower lumbar disc. (Slipped disc)
Treatment: David’s back low back pain was treated in three phases.
- Protection: establishing protection for the back in work and non-work environments.
- Rehab: rehabbing injured lumbar disc tissue.
- Self Care: establishing a self-care program for preventing re-injuries and managing flare ups.
Results: David’s low back pain was brought under control within 3 weeks. His crossfit workout program was retooled for his specific needs over the next 4 weeks. At this time, David works out 5 times per week, and he manages his discogenic pain himself.
Case Study 3: Senior Athlete
Description: Janet is a 59 year old Red Cross worker and a road bike enthusiast who is attempting a ride across America in 6 months but is considering dropping out due to the pain.
Symptoms: Janet has had longstanding neck pain during traveling and biking that has made her reconsider a new passion in place of biking.
Diagnosis: chronic degenerative disc disease of the neck (cervical spine)
Treatment Plan: Janet’s neck condition was treated in our three phase approach to care.
Phase 1: Protection – protecting Janet’s neck from prolonged positional overload by modifying her ride position.
Phase 2: Rehab – treating chronic upper back muscles with soft-tissue techniques such as ART to reestablish normal tone.
Phase 3: SelfCare -Develop a self management plan to maintain strength to the upper back and neck muscles while maintaining mobility with a trigger point roller t her thoracic spine.
Results: Janet finished her across the country ride in June of 2010 and has since written a book about her experiences. She has continued to manage her pain with minimal involvement from SpineCare.
Case Study 4: Engineer
Description: Mark is a 36 year old software engineer that has been dealing with intermittent mid back pain for the last 5 years. Just recently, he was in an auto accident and the pain that was once intermittent has now become constant.
Symptoms: Mark’s mid back pain is located between the right shoulder blade and spine and moves up into the lower neck area the longer he programs or drives. And if has really gets going he can sometimes get numbness and tingling into the right arm.
Condition: thoracic kypho scoliosis with concomitan cervical disc degeneration. (Poor posture due to years of programming)
Treatment Plan: Phase 1: Protection – Marks job duties put him at an increased risk of delayed recovery from a trauma due to his high volume sitting. So a sit/stand workstation was recommended.
Phase 2: Rehab – Next the goal was to restore proper mobility to the thoracic spine and to improve his posture thus reducing the load on his lower neck.
Phase 3: SelfCare – Lastly, we designed a strengthening program to to build on the mobility we restored to help ensure the postural changes remain.
Results: Marks neck pain and numbness was brought under better control, and the changes to his workstation translated to a reduction in both frequency and severity of aggravations. Most importantly though, Mark has an understanding of why this is happening and how to manage it going forward.
Case Study 5: Young Athlete
Description: McKenzie is a 13 year old female club soccer player.
Symptoms: She is presenting with a nagging right hip pain and lateral knee pain that is worse after playing soccer and sprinting.
Condition: Glute mediums weakness with secondary compensation of IT Band, TFL and Piriformis muscles. The trochanteric bursa is also inflamed.
Treatment: We attacked this condition with our three phase approach.
Phase 1: Protection -Initially, our goal was to protect her Lumbopelvic weakness from overtaxing activities. So, eliminating sprinting and limiting soccer was essential.
Phase 2: Rehab – Next, strengthening her Lumbopelvic stability and well as imbalances indentified during her functional movement screen (FMS) was the next step.
Phase 3: SelfCare – Lastly, once her abnormal movement patterns have been normalized and the unhealthy compensation brought under control, a workout regime was established. Periodically, we would retest, to ensure fundamental movement patterns were being maintained.
Results: Mckenzie’s hip pain abolished and was maintained after finishing the rehab program and was able to resume her competitive soccer schedule. She has had no recurrence.