Case Study: Low Back Pain and Sciatica

April 1, 2016

by Dr. Jody Gilligan

When someone comes in with this secondary condition such as low back pain and sciatica, I already have a list of MULTIPLE causes, that I am not surprised to discover in the Complete Structural Exam. Here’s an example of a recent case:

Case study

55 y/o athletic male
Constant low back pain and sciatica

The patient presented to our office after talking to another one of our patients.  He stated that the issue started gradually around 4 years ago and has been progressively worsening. The pain in the low back he was experiencing referred pain down the back of the left leg, into the foot were it also produced burning, numbness and tingling. Activities such as sitting, driving and general chores are effected as are sleep quality, using the computer, getting in/out of the car, bending over and standing for any length of time.

This guy is a real-dad… He doesn’t want to get sidelined by a bad-back.

Before coming here, he had consulted with two neurosurgeons and was receiving ongoing physical therapy and performing home exercises.

What We Did

After the first structural correction visit, the patient felt that he was on the right track. The progress was very noticeable around the 4^th week of corrective care.

After 8 weeks and 24 visits, the patient reported a complete resolution of his symptoms  (secondary condition). The sciatica, the numbness and tingling, everything. His activities of daily living were no longer effected by his condition.

Complete Structural Correction Exam Findings

Pre Corrective Care

·         Significant anterior head and pelvis translation

·         Mild right head shift and significant posterior rotation or the right side of the thoracic spine and left side of the pelvis

·         Left low shoulder, right low hip

·         8 lbs heavier on the right leg when standing

·         Structural radiographs (x-ray): 12mm Leg Length Discrepancy (right congenital short leg) with a compensatory right thoracic translation. Mild degenerative L5 retrolisthesis with significant posterior disc wedging and 20% loss of L4 and L5 disc heights. Mild lumbar hyper-lordosis.

·         MRI of the low back demonstrated a L5 herniated disc

How We Did It

Initial Phase of Correction

Based on these findings I recommended that the patient receive 3 Structural Corrections per week, over an 8 week period, for a total of 24 visits.

In this case, each visit began with corrective movement patterns and Structural Corrective Exercises. This is to establish correct motor-control of tissues that have been affected by the loss of normal structure. It’s also a great warm-up for what comes next; deep mobilization to the soft tissues and joints using a combination of tools, the Spinal Remodeling Table and the Soft Tissue Correction devices. NOT to be confused with massage, these tools address various properties of different tissues that have to be corrected for the spine to shift back into its normal ranges.

Additionally, more movement and stimulation is specifically applied to the structure of the spine BEFORE the patient was checked for and adjusted (when necessary) for a segmental shift (subluxation).

Finally, on just about every visit the patient also learns more about taking care of themselves. I’ll leave the details out, but it’s much more than a strip of rubber and an ice-pack.

Post Corrective Care

·         Reduced head and pelvis anterior translation to normal range

·         Level shoulders and hips

·         7lbs heavier on the right leg compared to the left in standing position (can’t win everything but he knows how to work on this)

·         L5 retrolisthesis was reduced to negligible amount with L4 and L5 disc heights restored to 100%. The lordosis is normal.

What Did We Do That’s So Different?

Structural Correction Technique is focused on directing the spine back toward its normal range. I look at the structural shift as the PRIMARY problem and all of the other variables/conditions as SECONDARY. The actual symptom, in this case sciatica, is TERTIARY. In other words, I focus on correcting the underlying framework to get my patients to function optimally and feel great.

Consultations Are NOT Sales Pitches!

We totally understand why people are leery of chiropractors. The gimmicks, scams, ambulance chasing and crazy claims haven't helped our profession...it's embarrassing for us and we don't know any better way to show people what we do, and why we are different, than with a consultation.

Consultations are NOT sales pitches, they are NOT a commitment to anything and they are definitely not us preaching down to you or bashing everything you know. They are just an opportunity for us to meet and discuss your problem(s) and for us to explain what we do (Structural Correction) and how it is different from what you may have tried.

Since we consider the consultation to be an opportunity for us, we do not charge anything.They are quick, 20-30 minutes, and don't require anything more than a smile and a hand shake. We want you to choose us because you understand our approach and we want to meet you and see if you would be a good fit for the office. After all, we know we are not for everybody, but we would like everybody to understand what we are all about. 

Call the office 561-826-7101 or email us at info@correctivedoc.com to schedule a private consultation when you are ready.

Structural Chiropractic vs. Traditional Chiropractic

Prolotherapy... Good, Bad, Evil????

Yikes!

There are many tools and techniques to choose from in the world of medicine. Recently I’ve been asked about what I thought about prolotherapy…is it good, bad, evil?

Well, let’s go over it…

The first thing you have to realize is that you need to love needles…or at least tolerate them.  Prolotherapy involves injecting dextrose, lidocaine (a common local anesthetic), phenol, glycerine, or cod liver oil extract into a really flimsy, overstretched tendons or ligaments for the purpose of strengthening the suspect tissue to try and relieve musculoskeletal pain.

Prolotherapy sessions are done every three to six weeks, gradually tapering off over time until they are, hopefully, no longer needed.

Like any technique, there is a bit of an “art” to it. So the more experienced the doctor is the better. You don’t want someone to “practice” this on you.

The concept is simple. A joint is forced to move more than it’s designed and its tendons or ligaments become flimsy. However, unlike a muscle, you can’t make tendons and ligaments stronger with resistance training. Instead, the trick is to somehow get them to shrivel up, get shorter and thicker...the body's natural response to direct trauma with a sharp instrument. Kind of like a face lift.

Or you could remove the perpetual cause…but we’ll get to that later.

Basically, prolotherapy injections irritate the heck out of the involved tissue to get it to thicken-up and get stiffer. That’s the goal. Essentially it’s a skillfully applied scar.

Another technique, referred to as “needling”, has a similar objective. Picture a Roman doctor stabbing a hot needle into a gladiators “unstable” shoulder. Today’s less barbaric version of needling is becoming very common to use on horses.  And now that I’m thinking about it Platelet Rich Plasma (PRP) Therapy probably works via the same mechanism, and may have nothing to do with the red blood cells or the growth factor they try to inject.

There’s a good history with this approach. But other than direct injury, why would someone, other than a gladiator, need to give their ligaments and/or tendons a face lift?

Well, like any chain, if there is a rusty link, the adjacent link will move more than it’s designed to, and wear out faster than normal. In this case, the ligaments that are suppose to limit the joints motion, and the tendons that the muscles use to move and stabilize the joint, can get trashed over time, if the joint is forced to compensate for an adjacent “rusted” joint.

If you have any structural abnormality, you will have a bunch of “rusty” joints, all over your body, which will force their neighbors (above, below, other side) to become “flimsy” to one degree or another.

“Flimsy”, hypermobile joints are usually the ones that end up hurting. Naturally, these are the ones that can be candidates for prolotherapy.

But, you have to ask yourself…What’s the sense in doing prolotherapy on a joint that is just going to get loose again anyway? It’s like lubing the loose links and ignoring the rusty ones.

This is how I think.

The PRIMARY conditions, that can lead to a joint-hypermobility, that I focus on correcting, include: Short Leg Syndrome, Compensatory Lumbar Scoliosis and Anterior Head Syndrome… which result in the loss of the normal loading of the vertebrae, resulting in abnormal joint movement, abnormal mechanoreception (joint dysafferentation in general) which is never limited to the spine, because the extremities almost always end up getting caught up in the mix. Especially the lower ones

It’s valuable to understand how things are connected. How a SYSTEM works. How the hip bone is connected to the…

So, for some patients, prolotherapy is a possibility.  It takes advantage of the body's natural reaction to direct trauma, skillfully applied with a needle, hopefully. It's not good, bad or evil...it just doesn't make sense if you aren't going to provide the hypermobile joints a better environment, by giving the “flimsy” joints some slack, to reduce or eliminate the primary condition (rusty link).

Of course there is the occasional exception…Some links just can't get unstuck.

"Pop n Pray"

Wow! I was just blown away today when I heard this saying come out of a complete stranger’s mouth…“Pop n Pray” is a derogatory term that is usually used to describe Traditional chiropractic, and because of that I’ve NEVER said it around patients. I love Traditional chiropractic, and think it truly helps people who don’t have any structural-abnormalities of the spine or live somewhere were they don’t have any other option.

I just couldn't believe my ears. My jaw literally dropped when he said it. It was incredible hearing it come from someone I just met and wasn't another chiropractor like myself.  Prior to today, I only heard this at technique seminars.

Here’s what happened, best I can remember…

I dropped by the coffee shop and on my way out this guy saw my race bike and asked me a few questions which led to a conversation about what I did for a living, since I can’t make money racing bikes (I must look like a pro, lol!)…We were talking about bike racing and he mentioned that he had a bad crash while racing BMX. Turns out he broke his pelvis, but the hospital somehow missed it. It wasn't until he went to a chiropractor, who focused on structural correction (not his exact words but mentioned another structural technique) picked it up during his structural exam.   

Luckily, he had a great experience that wasn’t limited to just that chiropractor either, as he needed surgery and physical therapy as well.  I was just as shocked that he went to a structural-based chiropractor. There's not that many of us!  When I told him that my practice was limited to structural correction, like his old chiro, he replied, “regular chiropractic is just pop n pray”.

I wanted to high-five him…but I like to downplay that stuff in public. I really do appreciate traditional or “regular” chiropractic…the chiropractors are a different story all together, sadly.

Anyway, this chance meeting got me thinking more about the differences between Traditional chiropractic care and Corrective Chiropractic’s Structural Corrective care. It’s something I need to work on personally, so I can communicate what I do…it's something that takes more than a catch-phrase.

Traditional

Corrective Chiropractic

Increases ranges of motion Decreases muscle spasm Decreases pain Most common form of chiropractic care you can find There are many techniques or styles that use anything from the well-know hands-on “cracks”/manual manipulations/adjustments to low force instruments to achieve their goals

Complete Structural Examination…no guessing, no “pop n pray” Restores spine back to its normal ranges Restores normal function of the spine and pelvis Complimentary Requirements that leave almost “no-stone unturned” from the ground up Increases ranges of motion Decreases muscle spasm Decreases pain After your care is complete, which takes TIME, the Complete Structural Exam is repeated so we can measure and SEE the correction you attained   Educate patients on how to maintain their correction so they are not dependent on us FOREVER. We want you to keep your correction We do not cater to the insurance company’s standards nor are we limited to their coverage Take pride in NOT SETTLING, so we NEVER stop searching for ways to provide a better service

Most of my patients come here, or to similar style practitioners, because they were tired of patching up a problem that returns over and over again.  They were not SEEING or feeling the results they expected because the underlying structural abnormality problem was perpetuating their problem. An uncommon approach that made a lasting impression on this guy. It really made my day.

Fantastic Structural Correction!

This Is What It's All About...

Fireworks don't work for  me like an excellent structural correction...It never gets old...

The BLACK curve is the shape this neck is suppose to have. The red lines on the back of the vertebrae depict how the patient's neck is shaped...NOT so good (reversed) in the BEFORE image...BTW, they had a couple SECONDARY CONDITIONS which made them seek my care... headaches and neck pain, which are just a couple of the possibilities this kind of ABNORMAL neck structure can generate.

It took more than a couple treatments  to get the CORRECTION you see in the AFTER image...near perfection! The patient's favorite side effect of NORMAL structure, in this case, is no more headaches and no neck pain...no more SECONDARY CONDITIONS!!! That's great...I just like to think about the slowed rate of degeneration, less stress on the nervous system, etc...you know, the really big things that matter most.

Just an example how STRUCTURAL CORRECTION has a different OBJECTIVE compared to TRADITIONAL CHIROPRACTIC. Have a fun 4th!!!

POOR POSTURE IS SCREWING YOU OVER!

The Psychology and Physiology of Posture

I never had a doubt about the relationship between POSTURE and your mental-state AS WELL AS your hormonal-state. It's just kinda hard to tell someone that they will change their physiology and psychology if they just "fix" their posture.


Just take a look around at people's posture and you'll notice who seems more authoritarian and who looks more like a follower. Think of the mad scientist and their hunchback side kick. Got it?

Now the impact of good posture on your physiology (especially your hormonal levels) is well known...Unfortunately you can't bottle it and sell it at a profit...Can't make a living out of telling people to sit up straight for their "low-T"...or whatever the new thing is. 


The article below is a nice easy read...if you want more details. But if you're wondering what's my stake in this game...well it's pretty basic. NOT everyone can maintain normal posture to take advantage of its benefits, because their is a problem with the structure of the spine (PAIN, ARTHRITIS, DISC PROBLEMS, DEFORMITY, ETC)...and since all I do is FOCUS ON STRUCTURAL CORRECTION...who better to discuss your STRUCTURAL problems than me!

How You Can Become More Powerful by Literally Standing Tall

Posture can affect how powerful you feel--and how powerful you are

By Adam D. Galinsky and Li Huang  | January 4, 2011

"More impressively, expansive postures also altered the participants’ hormone levels. Using salivary samples, Carney and colleagues found that expansive postures led individuals to experience elevated testosterone (T) and decreased cortisol (C). This neuroendocrine profile of High T and Low C has been consistently linked to such outcomes as disease resistance and leadership abilities. Although past research has found that occupying a powerful role leads to expansive postures, Carney et al.’s paper is the first to investigate the reciprocal relationship – the causal effect of posture on the mental experience of power.

Along with Deborah Gruenfeld and Lucia Guillory from Stanford University, we have further established the primacy of posture. In our studies, also appearing in Psychological Science, we empirically demonstrated that not only does expansive posture predict power-related behavior, but it might actually be the closest correlate of these behaviors. Across three studies, we found that when individuals were placed in high- or low-power roles while adopting an expansive or constricted posture, only posture affected the implicit activation of power, the taking of action, and the tendency to see the forest instead of the trees."

NORMAL STRUCTURE EQUALS NORMAL POSTURE