Today is Wednesday February 11th, 2009. Problem: I had a lady see me in the Decatur Disc Treatment Center today that had four previous surgeries with the last two being fusions. She had her first neck surgery in 1993 and her last low back surgery in 2007. She was in intense pain all the time. She described the pain as 9/10. She had neck pain with radicular symptoms into her hands bilaterally. She had low back pain radiating down her left leg to the inside of the left foot. Her left thumb and first two fingers were numb on the right and her great toe was numb on the left. She came to my office in tears. I first saw her in December 08 and told her she needed pain control; two new MRIs; and a Nerve Conduction study of the upper and lower extremities. I told her pain control was going to take sometime but she wanted a quick fix. She left in December and went to a pain doctor who did exactly what I said and ordered new MRi's of the cervical and lumbar spine an NCV of the upper and lower extremities. After looking over the studies the pain doctor decided to put her on heavy meds and see her for monthly for refills. She did not want to take large quantities of meds and came back to see me for treatment. Yes she has recurrent bulges and adjacent segment syndrome. The MRI's were ordered without contrast so it's nearly impossible to see if any adhesion of scar tissues have occurred. Treatment Plan: I am starting her on conservative chiropractic care (Activator only no manual adjustments) and the disc pump for the cervical and lumbar spine. I will do some Cox Flex/Dist work on her. I am also consulting with UAB Dept of Neurosurgery as I think she is a candidate for Pulsed Radio Frequency treatments to the lumbar facets or perhaps an internal cord stimulator. I will start her on modality treatments including IFC and Short Wave Diathermy for deep heating. We will have to do some trigger point and deep tissue work to help her heal. I am consulting in Gary Cohen, DO Physical Medicine for IMS/NMS dry needling of the lumbar paraspinal muscles, SI Joints and traps. And I'm consulting in Michael Dick MD for treatment of the OA and Bursitis. I put her on vitamins, fish oil, glucosamine sulfate, Boswella and B-6 vitamin. I see pool therapy in her near future. I told her today It's going to take a year to get feeling better. Results: Too New to rate, I will let you know.
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