In 1993, Will, a 49-year-old pipeline welder started experiencing back pain. At first he believed the pain was due to normal muscle strain after working hard on the job, but many years later the pain still hadn't subsided, and had become increasingly worse. In 2002, Will was experiencing higher levels of pain in his lower back, and pain traveling down the back of his left leg. Over the course of a year this pain grew into a stabbing sensation in his thigh, that would come and go in electric shock like bursts. Will was having a difficut time working with sudden onsets of debilitating pain so he decided to take some time off from work and consult his doctor. Will's first examination by his primary care physician consisted of testing his flexibility and checking his back muscles for stiffness and spasms after performing load bearing exercises. Will's doctor found signs of a muscle strain, so he sent him home with a prescription of ibuprofen, and advised Will to take some time off work to rest. Taking things easy after two weeks off from work hadn't improved Will's condition, so he returned to see his doctor. X-rays were taken and the doctor discovered signs of arthritis in Will's spine. The doctor wasn't sure of his diagnosis, so he reffered Will to a spine therapy specialist to undergo physical therapy in hopes that the pain might be alleviated after strengthening the back muscles. If the back pain still didn't improve after taking these measures, an MRI (magnetic resonance imaging) of the lumbar area would be considered. Low back pain is the fifth most common reason for all physician visits in the United States, [1] so when doctors see patients with cases of chronic lower back pain like Will's, they typically suggest medicati... ... middle of paper ... ...her important consideration is that artificial disc replacement surgery requires an anterior approach through the stomach, and can cause major damage to important blood vessels, intestines, and urinary system components. Will's herniated discs are located in the lower lumbar region, and these vertabae have a low degree of flexation compared to vertabrae higher up in the spine. This means that replacement discs won't aid that much in retaining mobility, and lumbar fusion won't reduce flexation by that high of a degree. The experience of the surgeon should also be taken into consideration, and few surgeons have adequate experience with total disc replacement at this time. These reasons lead me to believe that a lumbar fusion would be the safest surgery for Will, providing adequate pain relief, and wouldn't limit his range of motion enough to warrant replacement discs.
Based upon previous knowledge of spinal cord function, what results from the testing were consistent with a spinal cord injury?
Labiaplasty refers to the plastic surgery procedure that is designed to change the shape, asymmetry and/or size of the labia. The labia are the lips that surround the vagina. There are two sets of lips surrounding the vagina, the labia major, which are the large, outer lips and the labia minor, which are the small inner vaginal lips.
Huntington, W. V., Covington, L. A., Center, P. P., & Manchikanti, L. (2011). Patient Protection and Affordable Care Act of 2010: reforming the health care reform for the new decade. Pain Physician
The word “chiropractor” has two word origins, the Greek words cheir and praxis; meanwhile, cheir means “hand” and praxis means “practice.” Also, most of the work that chiropractors do is done by hand (Pike para. 5). In 2002, going to a chiropractor was found to be the most commonly used program for therapy. Seventy-four percent, about 4 million, of people that had back pain went to a chiropractor to get treated. Among that 74 percent of people, 66 percent of them stated that they got “a great benefit” (Pike para. 9). Many chiropractors work full time but 1 out of 3 chiropractors work part time. Chiropractors work whenever their patients need them, even on w...
Currently, I am involved in a prospective cohort study with other colleagues from King Fahad Medical City that aims to study the effect of a low back care educational program on low back pain prevalence among health-care professionals.
J.P., a 58 year old female, presents to the Emergency Room on March 18th. She has a past medical history of cervical cancer, atheroembolism of the left lower extremity, fistula of the vagina, peripheral vascular disease, neuropathy, glaucoma, GERD, depression, hypertension, chronic kidney disease, and sickle cell anemia. She complains of right lower extremity pain accompanied by fatigue, a decreased appetite, increased work of breathing, burning on urination, and decreased urine output for three days.
Tests after tests including MRI’s, X-rays, and experimental procedures were performed to show I had five ruptured disks in the lower lumbar section of my back. Tedious Examination done by a group of doctors concluded I had a crippling disease of the spinal column called spinal stenosis. Spinal stenosis is a narrowing of the spinal canal that causes compression of the spinal cord. (Lohr,1) If this disease was ignored any longer, it would lead to many other problems affecting other areas of my back to help support this weakness. It was an extremely rare case for an athlete my age.
Total Hip Replacement (THR) is a surgical procedure that relieves pain from most kinds of hip arthritis, thus helping to improve the quality of life for the majority of the patients that undergo the operation. Arthritis simply means "inflammation of a joint." Arthritis can occur in any joint in the body. The main symptom of arthritis is pain which usually worsens with activity and weight bearing. This pain may be relieved most of the time through rest. There are over 100 types of arthritis but less than a handful account for over than 95 percent of the hip replacements that are performed. Some of these include Osteoarthritis (causes deterioration of the cartilage and the growth of bone spurs), Rheumatoid arthritis and Osteonecrosis of the femoral head. Doctors suggest that before considering hip replacement surgery for arthritis that the patient tries a number of non-operative interventions. Your doctor may have you consider little things such as weight loss (most arthritis is caused due to the weight bearing on a joint), activity modification or even the use of a cane. Patients should consider THR when daily living activities become harder to accomplish due to the pain. These activities would include walking, climbing stairs or other moderate pastimes. Anti-inflammatory medications which will help reduce the inflammation from the arthritis and reduce your pain may also be prescribed by the patient's doctor.
Herniate discs are very common and become more common with age. However, not all herniated discs will cause symptoms. Research shows that 30% of 20-year-old’s have disc herniation with no back pain as well as 84% of 80-year
Barta on 11/6/17. He reports that the change in physical was due to the physical therapist he was working with. He reports he felt like “repeating the same thing was like insanity”. He feels a change of location may help him to gain more strength and endurance. He reports both of his parents went to this location. He had his initial evaluation today and will start therapy on 11/9/17. Mr. Barta had questions regarding the favored work and compensation. I directed Mr. Barta to speak with the adjuster regarding that. Mr. Rider would be happy to provide further information.
Weight 195.2 pounds, BP 118/68, pulse rate 63, temperature 97.4, respiration rate 14. The gait once again is not antalgic. He can perform a full squat without difficulty. Single leg squats reveal knee adduction bilaterally, which is mild. Palpation of the lower back shows only mild tenderness at the lower lumbar paraspinals and only at the right sciatic notch, not at the sciatic nerve trunk exit. Motor power in the lower extremities is at the 4+/5 both proximally and distally. Sensation remains diminished in the L5-S1 distribution. Reflexes were present at the knees bilaterally and absent at the right ankle, but now present at the left. Toes were downgoing. The straight leg raising maneuver was negative. The figure-of-four test revealed lower back pain
DOI: 5/26/2011. This a case of a 71 year-old male forklift driver who sustained a work-related injury to the lower back when he was stuck by another co-worker in the forklift. The patient was subsequently diagnosed with lumbar disc syndrome, spondylosis protrusion, multilevel, lumbar; annular phisher at the lumbar level, chronic lumbar pain, and chronic pain syndrome. MRI of the lumbar spine dated 03/26/2015 revealed mild to moderate multilevel degenerative changes of the lumbar spine most severe at the L4-L5 and L5-S1 levels. X-ray of the Lumbar spine dated 03/29/15 revealed mild to moderate multilevel degenerative disc disease but no fracture. As per physical therapy note dated 03/30/15, the patient completed 12 physical therapy visits. He
Urgent surgical intervention is more common in patients with an incomplete spinal injury. If the neurologic dysfunction worsens, urgent surgical intervention is necessary. The decision to operate depends on many circumstances. The cause and extent of the injury and spinal stability issues is to be taken in consideration. The type of surgery to be performed is decided by the surgeon. Surgery to treat a spinal injury involves decompressing the spine and stabilizing the spine. Surgery may not reverse spinal cord damage. However, decompression and spinal stabilization are important to prevent pain, deformity, and progression of neurologic deficits such as weakness, tingling, bowel or bladder
Lunges and squats are often referred to as the masters of lower body exercises. In addition to your legs, theses functional, compound exercises also work your buttocks. However, poor form, a muscle imbalance, the consistent overload on your knees, and the repetitive motion, can make these exercises wreak havoc on your knees. (See References 1) Not to fear, you can still strengthen and shape your glutes with do-able, effective exercise that are easy on your knees.
Spinal fusion stabilizes the spinal vertebra by fusing the disk spaces between the vertebra. The purpose of Lumbar fusion surgery is designed to help create solid bone between the adjoining vertebra. Classically Autograft bone has been used for fusion. This case study demonstrates the successful use of a synthetic bone graft called Signafuse. Signafuse is a moldable bone graft comprising a proprietary combination of patented bioactive glass particles and biphasic mineral granules suspended in a patented resorbable polymer carrier.