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Sciatica Pain or Subluxated Sacroilliac Joint Pain

August 15, 2011 by drburt

Last month I had two patients who came to my clinic because they thought they had sciatica pain. One of the patients has self diagnosed himself and the other patient was diagnosed by a medical doctor. Both of these patients had excruciating pain in their lower back, which radiated down to a lower extremity. It is very common that many patients will wait for their pain to go away with rest, anti-inflammatory and pain medication. As a result, pain symptoms will get worse and get to the point where pain medications will stop working.

The first patient was a male in his early 60’s. He came to my clinic on his crutches. The pain level was so intense that he was not able to support his upper body. The pain would shoot all the way down his right lower extremity past the knee level but did not effect his toes. After thorough examination it was evident that his right SI (sacroiliac joint) was about 2 inches lower than the left SI joint. All of the nerves that were exiting from sacral foraminas (openings) were very irritated and inflamed. Every time this gentleman would place a load on his legs he would cry and I could see tears of pain on his face. After three sessions of full spine chiropractic adjustment, physical therapy (moist heat and electrical stimulation) and deep tissue massage from my CMT (Certified Massage Therapist) he was completely free of pain. I have recommended him to stop by once or twice a month for maintenance care in order to avoid future flare up and pain.

The second patient was a female in her early 50’s. She has had very similar symptoms as the patient I have mentioned above. Her medical Doctor diagnosed her with sciatica and prescribed her pain medications, which eventually stopped working. The examination finding were very similar to a patient I have mentioned above, except the part that the pain symptoms were on a left side. The pain intensity was so great that it would wake her up at night. The treatment parameters were the same with addition of stretching to her lower back and some dietary changes. She was also advised on taking more frequent brakes from prolonged sitting that her job required. After 4 sessions she was pain free and was advised on a once a month maintenance care.

Sciatica Pain and Misaligned Sacroiliac Joint are two conditions that can be misdiagnosed or misunderstood by patients and other medical care providers. It takes much longer for a patient with Sciatica nerve entrapment to respond to a care. Often times Sciatic Pain is presented in athletes with intense training. In conclusion I would like to say that it is important to treat the cause of the problem instead of masking it with pain killers and anti-inflammatory medications. The sooner the cause is fixed the faster the road to recovery is.

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Personal Injury Case and Arbitration

May 11, 2011 by drburt

Today’s post is not so much about health but about personal injury case, arbitration and insurance company which does not wish to compensate injured patient after he was involved in a car accident. I had an opportunity to present the case for one of my patients against insurance company which is not willing to compensate him for pain and suffering post motor vehicle accident. Besides my patient and me, the plaintiff attorney was in the room and neurologist who helped to manage the care when the pain level was unbearable for my patient. On the other side was a defense attorney and defense orthopedist (insurance company is using this orthopedist deliberately for reporting purposes only – about this later). The last person was a gentleman who was in the middle of this madness – the Arbitrator.

The arbitration process is not as serious as a deposition or a trial for personal injury cases. The process began by cross examining the patient from defense and plaintiff sides. I was not allowed to be present in the room during this process. The second cross examination was for a neurologist who was co managing the care for this patient. Again I was not allowed to be present in the room during this process. I was a third person to be crossed examined by both sides. Plaintiff attorney began asking me questions about pre and post health condition of this particular patient. The main complaint of the patient was persistent lower back pain which radiated down his left lower extremity. The questions were very specific and were leading to a specific conclusion – that this particular injured individual has never had shooting lower back pain prior to this accident. My thorough documentation has proved that this was the case. When the time came for a defense attorney to cross examine me, that person completely relied on an orthopedist’s report, which was obviously geared towards the benefit of the insurance company. The problem is that the defense orthopedist spent perhaps at the most thirty minutes with this patient and can not possibly know everything about his health history. Some anecdotal studies and examples were included in the report which had no supportive values for defense attorney and insurance company. Orthopedist does not have much of a clinical experience and is specializing in report writing only. This doctor was called for cross examination right after me.

The third party has wasted thousands of dollars on defense work instead of simply compensating the injured person. I am pretty sure that arbitrator will award this man a proper compensation for his pain and suffering.

Heart Attack or Thoracic Outlet Syndrome ?

January 3, 2011 by drburt

Today’s post is about real case that have treated on Friday. I saw this patient over a year ago for severe neck pain and headaches. Patient’s problem was resolved with very good results. This morning patient’s husband calls and asks me to see his wife today as an emergency visit because she has numbness in her left upper extremity, loss of temperature in that extremity, and shooting pain. Over the phone he explained to me what has happened couple of days ago.

He took his wife to a near by Hospital Emergency Room suspecting that she had a heart attack. She had severe shooting pain in her left upper chest and shooting pain down her arm. In a Hospital medical Doctors performed a complete check up, including laboratory test and fancy CT- Scan diagnostic. After numerous hours they found nothing wrong with his wife and discharge her home with some pain medications. She was not very happy with an outcome since the symptoms were still there even with pain medications.

This morning I performed my examination and was trying to figure out what was wrong with this lady. First off all she always carries her heavy bag on her left shoulder with her belongings and belongings for her two young kids. That was a first sign that the problem was mechanical in nature and something was compressing her arteries and nerves. Her intercostal muscles between first and second ribs were extremely painful. Her left clavicle (look at the picture on a left) was out of alignment and did not have any movements during passive and active range of motion. Both of her rhomboid major and rhomboid minor muscles were very sore as well.

My Solution to This Problem:

I have diagnosed this lady with TOS. The first procedure was the electrical stimulation and moist heat. I used electrical stimulation on PAIN and CONSTANT settings for 15 minutes. Two pads were placed on her first and seconds intercostal spaces and two pads were placed around rhomboid major and minor muscles. Moist heat pack was placed in the same area for 15 minutes as well. Next, my massage therapist worked on her tight muscles for about 20 minutes or so. My CMT has informed that her entire left side is completely out of balance. Muscles were tight and patient was guarding during the massage which made her job a bit more difficult. But she got it done. After the massage I have performed full spine Chiropractic Adjustment ( that included cervical, thoracic and lumbar spine) and I have adjusted her first rib and clavicle on the left side.

I have called later on today to follow with this patient. Patient has informed me that she did not feel any pain since I saw her this morning. She has also informed me that she felt wave of heat coming into the left side of her body and left upper extremity.

The moral of this case: – please carry your heavy bags on both shoulders if you have too. Make sure that your kids’ backpacks are not too heavy and they carry them on both shoulders as well. Let’s start 2011 with a healthy habit.

Happy New Year !!!

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Chiropractic Miracle Story While I was in a Student Clinic

December 15, 2010 by drburt

This is a story about five year old girl who was my patient while I was an intern in student clinic at Life Chiropractic College West. The life of this little girl was completely devastated by frequent urination symptoms. She had to go to the bathroom about six to seven times an hour. Can you imagine your life like this?

Prior coming to see me she was under the constant observation of her pediatric doctor. I don’t remember at this point and time the exact treatment parameters of her doctor, but I do remember that it did not work all. Her parents were desperate and were ready to try the unknown field of Chiropractic. Both parents were very concerned about the impact of this problem on development of their child.

I did a thorough chiropractic examination. I used Gonstead nervoscope to determine which vertebral level had the most inflammation. Nervoscope is very sensitive to heat. When you move it along the spine subluxated areas of the spine will be inflamed and will exert heat. An arrow on the nervoscope will move if such inflamed area is detected. My nervoscope had very strong reading at L4 vertebral level (read this post Relationship of the Nervous System and Spine to Organs). When I pressed the spinous process of L4 vertebrae with my thumb it was very sore and the girl jumped because of the pain level. Left rotation and left lateral bending were also restricted. Back then I did not have any physical therapy modalities and certainly did not have my own massage therapist. All I had was the power of chiropractic in my hands and my adjusting skills to help this little girl.

After first two visits the frequency of urination has gone down from six to seven times an hour to about two or three times an hour. After her sixth visit her symptoms disappeared completely and she stopped frequent urination completely. This happened about ten years ago and I am pretty sure if the problem would return she would be back in my office. But the only person I saw sometime in 2009 was her father for minor sprain in his right shoulder. I asked him how is his little girl is doing. He replied: “Little girl is not so little anymore, she turned into a princess.” Her father confirmed that the problem has never returned and she was fine ever since I saw her last time.

This is a video of Dr. Gonstead talking about the nervoscope