Chiropractic & Pain Case Studies

Case 1

  • 28 year Supervisor Auto body repair shop

  • Initial consultation 10/27/16

  • Found us by “Google search”

  • Chief Complaint “Low Back Pain"

  • Reported pain being there on and off for about a year

  • Started without any known trigger event

  • Worsened since 3-4 months prior

  • Saw Dr. K in Allen for three months to get Airrosti treatments

  • Pain was reported as Sharp in the low back, constant, occasionally radiating to both legs

  • Worse with sitting, driving, standing up holding his daughter

  • Had tried Ibuprofen and Massage in addition to Airrosti treatments.

  • Upon Exam he was unable to sit comfortably

  • Rated the pain as 9/10.

  • Pain upon percussion of the low lumbar region.

  • Normal neurological exam.

  • Prescribed muscle relaxant (Flexeril) 10 mg po qhs and hydrocodone 7.5-325 mg po tid prn.

Interlaminar Epidural Steroid Injection

Transforaminal Epidural Steroid Injection

  • First Lumbar Bilateral L5-S1 Transforaminal Epidural Steroid Injection 11/01/2016 > 30% Relief

  • Second Lumbar Bilateral L5-S1 Transforaminal Epidural Steroid Injection 11/29/2016 > 50% Relief

  • Third Lumbar Bilateral L5-S1 Transforaminal Epidural Steroid Injection 12/27/2016 > 70% Relief

What if Patient’s symptoms continue?

  • Pain is now “Tolerable”

  • Patient referred to Dr. Mills Chiropractor to start chiropractic therapy with adjustments and physical therapy.

  • Emphasized importance of ongoing adjustments and physical therapy

  • No follow up with Pain needed

  • Happy camper J

  • No PCP > Spine Surgeon > Surgery > More problems down the road

  • No High Dose Narcotics > Dependence > Addiction > Impact of life/ Job

Facet Joint Injection

Discography

Surgical Options

Adjacent level disease

Down the Road…

What are the options for Disc related (Discogenic) pain other than fusion surgery?

Thermal Annuloplasty Endoscopic 

Intradiscal Plasma Rich Protein (PRP) Injection

Annular injection of Fibrin Sealant

Evidence?

Case 2

  • 65 year old female

  • Referred by Dr. Morgan Spine Surgeon for a “Cortisone Injection”

  • Complaining of severe Neck Pain on the left

  • Max 8/10 VAS

  • Past Medical History positive for low back pain under care of local Chiropractor in McKinney with great response.

  • Depression, GERD, Migraines, High Cholesterol

  • After patient’s back pain responded well to chiropractic care, she started getting adjustments on her neck.

  • After two sessions of adjustments, patient’s neck pain worsened to the point that she needed to go to the ED.

  • At the ED, X-ray of the cervical spine was performed and was negative for any “Red Flags”

  • Patient was discharged with NSAIDs, flexeril and hydrocodone.

  • She was then referred to Dr. Morgan spine surgeon and MRI of the Cervical Spine was ordered.

  • No indication for surgery based on imaging and normal neurological exam

  • Surgeon suggested a Cervical epidural steroid injection

  • Upon exam, cervical facet loading on the left was extremely painful.

  • Palpation of the cervical facet joints was also uncomfortable.

  • Patient was scheduled for fluoroscopic guided cervical facet joint injection both for diagnostic and therapeutic purposes

  • Patient was recommended to return back to her chiropractor for continued adjustments, keep working on her alignment as well as therapy for best long term outcome.

What if patient’s “Migraine” headaches go away after cervical facet injections?

Cervicogenic headaches  /  C2-3 Update

Cervicogenic headaches

What if the patient continues to have pain from the facet joints despite series of injections and chiropractic care?

Cervical Facet Radiofrequency Neurotomy

FIND OUT IF YOU'RE A CANDIDATE

Has your pain kept you from doing what you love? Meet Dr. Ghalambor today.

Dr. Ghalambor is a Harvard Fellowship Trained and Board Certified Specialist. 

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