Chiropractic & Pain Case Studies
Omid Ghalambor, MD, DABA, FIPP, DABIPP, DABPM
Case 3
Case 3 Details
- 28 year Supervisor Auto body repair shop
- Initial consultation 10/27/16
- Found us by “Google search”
- Chief Complaint “Low Back Pain"
- Reported pain being there on and off for about a year
- Started without any known trigger event
- Worsened since 3-4 months prior
- Prescribed muscle relaxant (Flexeril) 10 mg po qhs and hydrocodone 7.5-325 mg po tid prn.
- Saw Dr. K in Allen for three months to get Airrosti treatments
- Pain was reported as Sharp in the low back, constant, occasionally radiating to both legs
- Worse with sitting, driving, standing up holding his daughter
- Had tried Ibuprofen and Massage in addition to Airrosti treatments.
- Upon Exam he was unable to sit comfortably
- Rated the pain as 9/10.
- Pain upon percussion of the low lumbar region.
- Normal neurological exam.
What if Patient’s symptoms continue?
- First Lumbar Bilateral L5-S1 Transforaminal Epidural Steroid Injection 11/01/2016 > 30% Relief
- Second Lumbar Bilateral L5-S1 Transforaminal Epidural Steroid Injection 11/29/2016 > 50% Relief
- Third Lumbar Bilateral L5-S1 Transforaminal Epidural Steroid Injection 12/27/2016 > 70% Relief
Case 2
Case 2 Details
- 65 year old female
- Referred by Dr. Morgan Spine Surgeon for a “Cortisone Injection”
- Complaining of severe Neck Pain on the left
- Max 8/10 VAS
- Past Medical History positive for low back pain under care of local Chiropractor in McKinney with great response.
- Depression, GERD, Migraines, High Cholesterol
- Worsened since 3-4 months prior
Cervicogenic headaches / C2-3 Update
- After patient’s back pain responded well to chiropractic care, she started getting adjustments on her neck.
- After two sessions of adjustments, patient’s neck pain worsened to the point that she needed to go to the ED.
- At the ED, X-ray of the cervical spine was performed and was negative for any “Red Flags”
- Patient was discharged with NSAIDs, flexeril and hydrocodone.
- She was then referred to Dr. Morgan spine surgeon and MRI of the Cervical Spine was ordered.
- No indication for surgery based on imaging and normal neurological exam
- Surgeon suggested a Cervical epidural steroid injection
- Upon exam, cervical facet loading on the left was extremely painful.
- Palpation of the cervical facet joints was also uncomfortable.
- Patient was scheduled for fluoroscopic guided cervical facet joint injection both for diagnostic and therapeutic purposes
- Patient was recommended to return back to her chiropractor for continued adjustments, keep working on her alignment as well as therapy for best long term outcome.
Cervicogenic headaches
What if the patient continues to have pain from the facet joints despite series of injections and chiropractic care?
- Cervical Facet Radiofrequency Neurotomy
