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The Ultimate Back Pain Relief Tips Blog

Sciatica Treatment Case Report

Posted by Kristina Wert on Thu, May 15, 2014 @ 04:50 PM

 

A 35 year old male was treated at the Illinois back institute for severe Back Pain and Sciatica.  His case is as follows.

The patient presented to the clinic with back pain and leg pain that was not getting better. He has been experiencing pain for years. Six months ago the pain became intolerable.  On a scale of one to ten his pain was on average a 7 (10 being the most severe).  The pain was so bad that he could not work.  Before he came into the Illinois Back Institute he had tried many different therapies none of which helped, and in his words some made him worse.

The therapies he had tried before entering into the treatment at the Illinois back institute were as follows;

  1. Chiropractic
  2. Physical Therapy
  3. Epidural Shots
  4. Narcotic Medicine For Pain
  5. Wearing a Back Brace

His goal on entering our treatment was to get rid of the pain in his back and leg and more importantly avoid surgery. He heard about us on television and didn’t think the treatment would work because nothing else had, but he wanted to avoid surgery.

On day one he rated his pain a 7 (10 being the most severe) and his Oswestry Disability Index was scored at a 42 (0-100).  The index is an indicator of how well the patient can perform activities of daily living. The score is used as a way to measure the effect your pain has on your ability to live your life. The higher the score the more your life is effected by your pain.  Patients that score 42 don’t get better on their own and typically end up in surgery.  A score of 42 would indicate the patient was severely disabled from the pain.

The Oswestry disability index Scores are used as an indicator of disability and are as follows.

0-20  Minimal disability: This group can cope with most living activities. Usually no treatment is indicated, apart from advice on lifting, sitting posture, physical fitness, and diet.

20-40  Moderate disability: This group experiences more pain and problems with sitting, lifting, and standing.  Travel and social life are more difficult and they may well be off work.  The back condition can usually be managed by conservative means.

40-60  Severe disability: Pain remains the main problem in this group of patients. These patients require detailed investigation.

60-80  Crippled: Back pain impinges on all aspects of these patients’ lives. Positive intervention is required.

80-100  These patients are either bed-bound or exaggerating their symptoms.

Because all other interventions had not successfully helped our patient feel any better, and he continued to have a score of 42 indicating a severe disability from the pain, we were his last hope for regaining a normal life.

His MRI revealed he had a Grade 1 degenerative spondylolisthesis accompanied by diffuse disc bulge resulting in bilateral stenosis in his low back.

.Sciatica Pic 1

 At a second level in his low back he had a herniated disc that resulted in pinching of the sciatic nerve.

 Sciatica Pic 2

Our patient was experiencing complicated back problems that if did not get better we would be looking at a surgery on his spine.   The surgery of choice for this paint would most likely be a fusion of the vertebrae of his spine.  This is a very complicated and costly surgery with a lengthy recovery time.

 Sciatica Pic 4

Our evaluation revealed that the patient had issues with his posture that caused and increase in load on his discs.  He also had some muscle weakness in his primary stabilizers of his spine and his core. Our goal was to decrease the pain and facilitate healing in the disc and spine and reactive and strengthen his stabilizing muscle and correct his posture.

His treatment would be 3X per week for 3 months, and we would be performing our proprietary protocol of functional disc rehabilitation.

After 12 treatments his pain had dropped to a 4, and his ODI (Oswestry Disability Index) had lowered to a 32. I will talk more in future blog posts about the effect of treatment and ODI; there are some interesting examples of treatment outcomes based on the ODI. The ODI outcomes from fusion surgery may be surprising to most people because they are not very good.

After his 24th treatment we saw his pain go down to a 2 and his ODI at a 30.   Also, it was at this time that he started to have days where the pain was completely gone in his leg. 

He was improving at a steady pace as expected. He had very complicated back problems that were evident on his MRI.  He had tried 5 other therapies that failed to improve his condition, and he had a very high Oswestry score.  This combination we knew would indicate a slower recovery period.

Patients that have their problem for years tend to take a little longer but with persistence we see the scores improve and the patients start to feel better and get their life back.

After his 36th treatment the pain in his back and leg dropped all the way down to zero, and his ODI dropped below 20.

He was able to avoid surgery and get his life back.  Illinois back institute using functional disc rehabilitation is able to help eliminate some of the worst back problems and disabling pain.

Glad we could help!

Dr Jeff

 

 

Topics: Back Pain, sciatica pain relief, sciatica solutions, sciatica treatment, sciatica specialist