A 55 year old male patient with Neck and Low Back Herniated Discs and Sciatica, Treatment Case Report.
This case review is about a 55 year old male patient that had a herniated disc and pinched nerve in his neck and multiple herniated discs in his low back causing multiple pinched nerves. When he came in to see us he was unable to turn his head and he was stuck in a forward flexed position because of herniated discs in his low back.
He has a long history of back and neck pain that started after a car accident he suffered in 1978. He has experienced on and off pain over the last 30 years at times very severe. He had up to recently been able to manage his pains with conventional therapy consisting of the following.
1. Medications that included the following.
A. Narcotics that he could not tolerate. He would take them when he absolutely had to.
B. Muscle relaxants
D. Advil, which caused him to be admitted to the ER for bleeding ulcers (and now can’t take any Ibuprofen). His gastroenterologist insists that he no longer take the meds because they caused him severe bleeding ulcers.
2. He has seen a Chiropractor for 15 years. In the past the chiropractor could help him when the pain was bad. His most recent treatments with his chiropractor did nothing to help his condition.
3. He has had several sessions of physical therapy during that time offering some relief.
4. He had several epidural shots of cortisone in his spine. He felt better for a while and then the pain came back worse.
5. He saw a surgeon for his condition and was scheduled for surgery and at the last minute changed his mind. The surgery would require entry from the front and a fusion cage to be secured to his spine. He felt the surgery was too risky and thought it better to hold off on the surgery.
When he entered our clinic he was experiencing severe back and neck pain. He was also experiencing pain and numbness into his left arm. He was at the end of his rope because his normal treatment options that I wrote about earlier were no longer effective.
- An average day of pain for him was a 6 and throughout the day the pain would get worse. A bad day for him was a 10 and he had too many bad days.
- He struggled to drive and was becoming very unproductive at work because of the pain and numbness along with the fact that he couldn’t turn his head and was stuck in a flexed position.
When he entered our office his initial ODI for his neck was 42. ODI is an indicator of how the pain affects the quality your life. It’s also used as a tool to identify the level of improvement from your therapy.ODI is scored 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.
· His neck pain at a 42 would be considered a severe disability.
His neck pain over an extended period of time in conjunction with the fact that he couldn’t turn his head and was experiencing numbness in his left arm, made him a prime candidate for surgery. In his case we know this because he was scheduled for surgery and made a decision not to get the surgery.
- The MRI of his cervical spine revealed a herniated disc in his neck that was causing a pinched nerve.
His herniated disc in his neck was complicated by the fact that he had a reverse cervical curve. The neck should have what is known as a lordosis and he had a kyphosis. This is typically the result of a whiplash and we know he suffered a whiplash in 1978. Whiplash will cause degeneration of the spinal joints and he was also suffering from this condition.
Cervical MRI Revealed
1. Herniated Disc
2. Pinched Nerve
3. Reversed Cervical Spine
4. Degenerative Joint Disease
• His ODI score for his low back was even worse than his neck.
His MRI revealed he was suffering from several herniated discs, and this was contributing to his score. He scored a 52 on his ODI and he was getting worse by the time he came to see us. This is definitely the danger zone; he was creeping slowly into the next category that is known as crippled. It called crippled because you are not able to live your life or even function in everyday life.
The MRI of his lower back revealed he had 5 major things going on.
1. Two large herniated disc
One of the herniation’s extruded outside the disc and down the spinal canal (The Worst Kind)
2. Pinched nerves
4. Disc Bulge
5. Flattened Lumbar spine
The herniated discs were compressing two lumbar nerves; this was the cause of his not being able to stand up straight.
- Our immediate goal was to take the pressure off the nerves in his neck and his low back.
Our program of functional disc rehydration is specifically designed to take pressure off nerves and heal the discs. After just 3 treatments he was feeling much better. Something he failed to achieve with his other treatments.
- Our long term goal was to slowly eliminate the herniated discs in his neck and low back.
When he started with our care his Neck Index score was 42 and his pain was up to a 10 on some days. After 12 treatments (one month) his neck index was down to a 28 and his pain on some days was at a zero. Because his neck was complicated with a reversed cervical curve after 12 more visits his neck index was down to a 24. Our goal is to as a minimum get all our patients down below 20. He is on target to reach that.
- A score of Fewer than 20 on the index is considered the safe zone. You can live your life almost without any compromise on activities in this zone.
His low back, because he had more issues in this region, had a higher score (52). Like his neck he was on his way to surgery for his low back. Very often when patient’s normal traditional treatments don’t work they wind up in the office of a surgeon. His normal traditional treatments were no longer effective.
- Without our treatment I am sure his next step would have been surgery.
His ODI score when we started was very high he was at a 52. After 12 treatments his ODI dropped to 30 and his pain was 60% better. After 12 more treatments, for a total of 24 treatments his ODI score was all the way down to 18, into the safe zone. And his low back pain was gone.
- When he started care he was stuck in a forward lean.
Part of the problem when he first came into our clinic was his herniated discs prevented him from standing up straight. One of the major contributing factors for having a back problem and disc problems is poor posture. We primarily focus on what is considered your forward lean. His score for forward lean when he entered our clinic was 14.6 our goal for our patients is to have them at a 0.
- After 12 visits his forward lean was at 4.9
- 24 visits his forward lean was 2.9 - Our goal is 0
Currently he is pain free with an occasional stiffness. He is fully functional and productive at work. He is able to engage in all activities even some I don’t recommend. He recently, over the last few weeks, was helping his children move furniture and I’m pleased to say he did it with smile…. Because he was doing it pain free.
We help many people with complicated back problems. Our program will get healing within the disc and take pressure off nerves. It’s one of a kind and very successful. If you have pain that is not going away you need to give us call and get your life back. And maybe you too can be so lucky that you can move furniture too………
Call the Illinois Back Institute today at 888-959-6823 and schedule a FREE CONSULTATION to ensure you are receiving the best care for your back and the best for your future.
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Dr. Jeff Winternheimer, D.C.