Chiropractic & Pain Case Studies
Oliver Ghalambor, MD, DABA, FIPP, DABIPP, DABPM
Case 1
- 44 year old male truck driver
- Complaining of low back pain of long standing constant low grade daily pain with recent gradual worsening
- Worse with sitting and bending
- Better with heat
- Previous treatments: Stretch, over the counter meds (NSAIDS, Tylenol)
- Exam suggestive of diffuse low back pain, neurological exam intact, good range of motion
- 8 session of adjustments
- Patient’s pain improved both in intensity, frequency and the area of pain was significantly reduced
- Motion of the spine upon palpation normalized
- However, patient continued to have pain in a focal area left low back
Spines Structures
Back Pain
- Affects 2/3 of adults
- 2nd most common reason for physician visit
- Most common reason for work disability
Disk Degeneration
Athritis
Exam Under Fluoroscopy
- Patient underwent left sided L3/4 and L4/5 lumbar facet injections
- Per patient request the procedure was done with local anesthesia only
Lumbar Facet Joint Injections
Case 1 Details
- Immediate post op response 100% pain relief
- 2 weeks later patient still has no back pain but continues to get adjustments
Facet Joint Injection
Facet Joint Medial Branches
Lumbar Radiofrequency Neurotomy (Rhizotomy)
Medial Branch Block
Case 2 Details
- 34 year old male coming from ER with diagnosis of sciatica
- Complaining of severe 8/10 VAS Low back right buttock and leg pain
- Started 3 weeks prior after playing softball. He was then also involved in a MVA a week prior to visit, which worsened symptoms
- Did complete exam. Disc Suspected
- Gave patient choice of daily chiro visits or to see pain and begin chiro once severe pain has decreased.
- He chose pain.
- Normal neurological exam
- Positive straight leg raise test at 15 degrees on the right side.
- Started on NSAIDs, muscle relaxant and low dose narcotics
- Ordered MRI
- L3/4 Right paracentral disc protrusion/extrusion as well as annular tear
- L4/5 Central to right paracentral disc extrusion as well as annular tear
