We, my chiropractic colleagues, see patients with spine and radicular pain who have underwent vast numbers of medical and surgical procedures without satisfactory relief of pain and disability. As chiropractic spine specialists, we are not commonly the first but rather the last intervention. We look at this as our opportunity to excel.
Therefore, when seeing this persistent postsurgical pain or another advanced care patient, start anew. Listen, but start a new program of review, examination, impression, treatment plan, and monitoring. Look behind the curtain of past care with a chiropractic eye.
Might an example be appropriate? This week a man was seen at the recommendation of his daughter who had been helped at our clinic with Cox® Technic Flexion Distraction and Decompression spinal manipulation and mobilization ten years ago. This man, her father, suffered incapacitating low back and buttock pain without radicular component. His medical care included bilateral intraforaminal injections, medications, therapies, and other pain injections.
Review of his MRI showed L3-4 spine stenosis with ligamentum flavum hypertrophy, Pfirrmann grade 2-3 disc degeneration with endplate degenerative change, facet arthrosis and foraminal stenosis. However, note no radicular signs or symptoms present. NOW, further study of the MRI revealed unreported spondylolisthesis of 8% with unilateral true spondylolytic pars interarticularis defect; thus understanding of the small L5 slippage in instability introduced by unilateral pars defect. Disc protrusion of the L5-S1 disc is seen. Coupled with clinical examination of high palpatory pain and motion palpation intense pain at L5-S1, a new direction of care was set. Doming of the diaphragm for hamstring lengthening (very prominent in spondylolisthesis), deep multifidees muscle strengthening along with erector spinae extension exercises, Protocol II Cox® Technic to the thoraco-lumbar and lumbosacral spine under careful tolerance testing, tetanizing current to the deep multifidees and erector spine, with nutrition support of Discat Plus Enhanced (with perna canaliculus [glycosaminoglycan]) and Disc & Joint Pain Relief Complex (turmeric root, curcumin, black pepper and other anti-inflammatory components), and bracing of the lumbosacral spine 24 hours a day for two months followed by diminished use and thereafter worn under bending, lifting and twisting persistent motions.
LOOK BEHIND THE CURTAIN. This is a rallying cry for chiropractic doctors when confronted by this growing epidemic of spine and radicular patients seeking our care. We have been preparing for this use of our specialized talents for a long time. Carpe Diem.
Perform exemplary clinical examinations, overread all diagnostic imaging, formulate your own diagnosis and treatment plan based on your specialty in Chiropractic.
Isn’t this how we chiropractors gained our present status and will continue to grow it?
Happy New Year 2023 as we all Look Behind The Curtain!
See you in Maui, Hawaii, February 25-26, 2023, where we can look some more together.
Jim Cox
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