The Patient

• 52 year old female with a history of lower back pain, mid back pain, sleep difficulties, and digestive troubles
• Patient is overweight by 30 pounds
• The patient had a traumatic spinal injury from a slip and fall 3 years ago, that was corrected by spinal surgery

The Patient’s Complaints

• Moderate to severe lower back pain, hip pain bilaterally, and pain down the back of the thighs
• The patient has difficulty walking normally and must use a cane due to her disturbed gait and balance

Snapshot of My Examination Findings

• Past surgical reports, X-ray evaluations, and MRIs were reviewed and revealed moderate to severe degenerative disc disease of the lumbar spine and showed the site of the surgery at L5S1.
• Patient demonstrates a loss of balance while standing and walking
• Guarding (protective movement and positioning) of the lower back and lower extremity
• Multiple areas of spinal subluxations (jammed spinal bones that irritate the nervous system) with focal tenderness to the lumbar vertebrae when pressed
• Painful range of motion of the lumbar spine in flexion and extension (worse in extension)
• Painful muscular fibers and trigger point activity around the lumbosacral spine and the hip areas bilaterally
• Positive orthopedic test for sciatic nerve irritation

My Diagnosis

• Lumbar Spine and Disc Degeneration
• Pain and Instability of the Lumbosacral Spine
• Subluxations of the Spine and Hip area, dysfunction and pain
• Sciatica

My Recommendations

• A course of 12 visits of integrative care to include the following:
• Chirporactic adjustments of the spine, and hip areas
• Myofascial release to the lower back, hips, and lower extremity areas performed by massage therapist
• Progressive therapeutic exercises targeting the lower back and core, with a focus on restoring normal balance
• Ice the lower lumbar spine at home as needed for 15 minutes per hour

The Prognosis

• Fair

Discussion

Lower back pain can be caused by many different things.  Causes range from simple joint dysfunction or sprain/strains, to joint degeneration or even internal organ disease.  My exam was critical in determining that this patient’s pain had a biomechanical cause.  It was the joints, muscles, and nerves that were involved.

Post-surgical cases can be the most difficult, due to internal weakness at and around the prior site of the surgery.  In this case, the weakness centered in the patient’s lumbosacral spine and in her core.  Following surgery she had rehabilitation, but the exercises she had learned were not continued. In time, she became de-conditioned, overweight, and developed a weak and unstable core.  This resulted in chronic back pain that is marked by episodes of aggravations and recovery.

One of the best solutions for chronic lower back pain, is chiropractic care with core stabilization exercises.  This combination can help keep the spine healthy and prevent repeated relapses.

Upon following our advice and treatment schedule, this patient has had an approximate 50% improvement in 4 weeks of care, with less pain,  improved balance, and increased range of motion.  She has had moments where she was able to walk without limping, but she still has a way to go.

Our Approach To Post-Surgical Chronic Lower Back Pain

If you were a new patient visiting our office, we always start with a thorough case history, consultation, and examination.  I may recommend diagnostic studies (x-ray or MRI) if I need more information. At this point, if I determine that care is appropriate and you decide to begin care, I will design a treatment plan for you.  If at any time I discover something beyond the scope of my practice, I won’t hesitate to contact your primary care provider to discuss a possible referral to another healthcare provider.

We follow a very effective  treatment strategy based on the letters ASR.  They stand for:

• A – Adjust (whole-body adjustment techniques)
• S – Support (spinal pelvic stabilizers and other joint supports)
• R – Rehabilitate (targeted exercise therapy/physical rehab)

Our Wellness Program Options

• Relief Care – We offer short-term plans for fast pain relief and recovery.  When many people seek care in our office they have one goal… relief.  So that’s where we start!  During this initial stage of intensive care, we have the following obligations: 1) To uncover the underlying cause of the health problem.  2) To suggest a care plan to produce the fastest results possible.  3) To offer ways patients can participate in their recovery.  4) To explain the value of exercise, nutrition and other aspects of wellness.

• Rehabilitative Care – We offer comprehensive plans for optimal recovery following injury.  Many of our clients want to continue corrective care into the next phase of care – the rehabilitative phase. Wisdom has taught us that long-lasting pain relief can be achieved only when complete healing occurs and your body returns to optimal function. This part of the healing process usually involves therapeutic exercises. We provide one-on-one coaching through this phase of care and focus on flexibility, strength, endurance, balance, and core-conditioning.

• Supportive/Wellness Care - We offer ongoing plans to help keep you active and feeling great.  Many of our clients enjoy regular chiropractic “checkups” and/or massage because they have found that they feel better, have more energy, and enjoy life more.

• Weight Loss & Detox Programs – our 30-day “Quick-Start” program can help you lose weight fast, detoxify, regain your energy, and enjoy life again!  Experience one-on-one counseling and personal attention from our holistic nutritionist, Stephanie Brabazon.  We may also use laser auriculotherapy to help you lose weight.  Laser therapy is non-invasive, requires no needles, and is painless. We see many overweight people that have tried diets but have failed because they have difficulty curbing their appetite and cravings. Our program helps to curb your appetite, depress hunger cravings, stimulate your metabolism to burn off extra calories, and correct internal body hormonal imbalances.

Our Passion

It’s our passion to help you feel great and be your best!

After meeting with Dr. Ken Goldman and discussing your heal goals, we will put together aspecific treatment plan just for you.  We have many natural therapies to consider – chiropractic, massage, exercise, nutritional counseling, and laser therapy techniques.  This strategy sets us apart from many other health practitioners, and gives our patients the best opportunity to achieve superior health.

We will do our best to find the cause of your problem and correct it.  If at any time we discover something beyond the scope of our practice, we won’t hesitate to refer you to another healthcare professional.

We accept most health insurance plans and provide a variety of affordable payment options (even for those without health insurance coverage).  We also accept car accident cases, work injuries, personal injuries, and sports injuries.

We don’t want you to have to resort to dangerous medicines, injections, or surgery.  Our approach is to use chiropractic care and other natural therapies (such as massage, rehab exercises, or nutrition) to correct your back pain quickly and  naturally.

We now have available a special type of cervical (neck) traction, called The Posture Pump.  This device provides effective relief and lasting correction for:

• Acute neck pain
• Chronic neck pain
• Headaches
• Disc bulges
• Disc herniations
• Forward head posture

In many cases, the Posture Pump device adds a needed complement to your in-office care.  A thorough evaluation will provide the necessary information to determine if the Posture Pump is right for you.  If you are interested in this device or have any questions about it, just ask.  You can learn more on the Posture Pump web site by clicking here.

The Posture Pump is safe, easy to use, and is covered by most insurance carriers.  It may be the missing piece of the puzzle to your optimal recovery.

The natural care we provide for auto injuries feels great and is very effective.  We get quick results that last.  Instead of just covering up your pain with mind-numbing medications, we focus on the injured areas and provide a variety of natural therapies to speed up your recovery.

We have been able to help people like you suffering from auto injuries such as:

• Whiplash (cervical acceleration deceleration trauma)
• Headaches
• Back Pain
• Shoulder Pain
• Arm, Elbow, or Wrist Pains
• Hip, Knee, Leg, or Foot Pains
• Muscular Spasms
• Joint Stiffness and Inflammation

Regardless if your condition, I’d like to remind you that our practice mission is: To Promote Superior Health Through Natural Therapy. We accomplish this through a holistic approach and integrative care – combining chiropractic, massage, exercise, nutritional counseling, and laser therapy techniques.

If you are seeking help for auto related injuries, we promise to do our best to first clearly diagnose your problem and correct it. On your initial visit we will carefully discuss the details of the accident and the nature of your injuries. We will then perform a careful and detailed examination.

At this point, if we feel that we can help you, we will develop a reasonable treatment plan and begin a course of treatment. Your treatment plan will vary based on your condition prior to the injury, and on the severity of your injury.

We typically recommend the combination of chiropractic care, massage therapy, and other natural therapies because they work the best to reduce pain quickly and will allow your body to heal more perfectly.  Natural healing provides lasting healing.

However, if after the examination or at any time during the course of treatment, we discover something beyond the scope of our practice, we will not hesitate to contact your other health care providers to discuss your possible referral to another health care professional.

We believe that the human body is a masterpiece and that your health is among your most valuable possessions. It’s our passion to share the amazing power of natural therapies with people like you, to help you feel great and be your best!

At this point in time, all of the services we recommend will be fully covered by your auto insurance. Many people express concern that your auto insurance rates will increase if you use the medical benefits on your policy.  Don’t be concerned about that because I believe it’s illegal for any auto insurance company to raise your rates for using the medical benefits on your policy.

Whiplash has numerous possible causes including motor vehicle accidents, roller coaster rides, sports injuries, and slips and falls. Car accidents are the most common cause, as there are many thousands of motor vehicle accidents in the United States every year – resulting in injuries and death.

Injuries caused by motor vehicle accidents range from mild to severe. The most common type of spinal injury is whiplash. This occurs when the head and cervical spine (the neck) is accelerated and then suddenly decelerated. Most whiplash injuries occur when you are sitting relaxed in your stationary car and you are unexpectedly rear-ended.

The time immediately after the accident is of critical importance. If severely injured, hopefully EMTs will arrive on the scene quickly and you will get the care you need. We have some of the best medical professionals in the world. What you do about your injuries in the next hours, days and weeks can forever affect your health.

If you’re involved in an accident, try not to be misled if the damage to your vehicle is minimal. Your body reacts very differently than metal, glass and plastic! Upon a rear-end impact, your body presses deeply into your seat. Your head moves with your body backwards until they reach the limits of your seat. Then, your body quickly changes directions and moves forward to the limit of your seat belt. Next, your head starts moving backward in the opposite direction. Because your head is unrestrained by your seat belt, your head is jerked backward and forward beyond its normal limits.

You can reduce the severity of a whiplash injury by wearing your seat belt properly, and making sure your headrest is adjusted to prevent your head from snapping over the seat.

Try not to minimize your injuries. Just as a car can have internal damage beyond the scraped pain on your bumper, your body can have deep injuries to your delicate spinal structures. Pain and stiffness of motion of varying severity will result from whiplash injuries. Often headaches appear, but can begin a week or more after the accident. These injuries can’t be healed by pain pills, muscle relaxers, or cervical collars. At this point, an immediate chiropractic examination is essential.

In my interview with a patient, I will conduct a thorough case history and detailed examination. I will review any imaging films or reports done at the emergency room or from other physicians. If I determine that it is safe to receive care at our office, I will make recommendations for your optimal recovery. In many cases, treatment can begin immediately.

In our office we have found that the integration of chiropractic care and massage therapy to be extremely effective in proper healing. Chiropractic adjustments of the spine and extremities helps restore proper position and motion of joints. Massage therapy targets the injured muscles and helps reduce pain, tension, and spasm, and promotes relaxation. You may also benefit from adjunctive therapies we can perform such as laser therapy, electrical stimulation, mechanical traction, therapeutic taping, or therapeutic stretching. We may prescribe a TENS unit (a small portable electrical stimulation device) or a series of home-based therapeutic exercises.

Since starting my practice in 1992, I’ve had the honor of helping hundreds of clients with a variety of neck injuries including whiplash. I’m very pleased with our integrated approach to patient care at Spectrum Wellness. Our care is top-notch and personal. Our goal is to help you to achieve superior health… and we will do everything in our power to help you get well and stay well after the trauma of a whiplash injury.