Friday, April 1, 2016

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 4th 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.