When it comes to severe lower back pain sometimes surgery is an option, however, chiropractic treatment can in some cases be the key to solving this kind of pain and therefore can save patients from needing to undergo lengthy and expensive surgeries. In the below case, Dr George Hardas Consultant Chiropractor was able to do just that through his treatment for a patient who had been recommended surgery.
Patient Presentation
The patient presented was a 40 year old male who came to me with acute lower back pain, he was referred to a Neurosurgeon
MRI showed at L5/S1 there is a left paracentral broadbased extrusion. Bilateral moderate to severe foraminal narrowing is seen, with possible right sided nerve root contact and left contact/impingement. There is impingement of the descending left S1 nerve root with posterior displacement.
Medical profile
Medications
200mg Palexia
300mg Lyrica
20mg Amitriptyline
15mg Mobic
Lumbo-pelvic
30° (L) leg
Extension – No abnormalities detected
Compression/Distraction – Not applicable
Ambulation – Antalgic
L4/S1 Ambulation – S1 no abnormalities detected and L4 no abnormalities detected
Adam’s – No abnormalities detected
Cough/Valsalva – No abnormalities detected
Slump Test (L) – Positive (L)
Numerical Pain Rating Score – 9/10
Neurosurgeon opinion
Advised the patient to have surgery and so the patient came to us for a second opinion
Presented with a history of left sided radicular pain which was controlled with analgesia and injection. Six months ago he had a reoccurrence of symptoms with pain now down the leg in the same distribution, in the back of the calf and is in agony. The pain is rated 9/10 on VAS and associated with numbness at the back of the calf. The patient has taken annual leave at work and I am unable to work in his current state. The pain is worse on sitting.
Impression: Left L5 radiculopathy with severe disability and weakness
Management Plan – A discussion regarding the natural history of disc prolapsed and that generally they do get better over time. Surgical management is considered when there are worsening symptoms accompanied by severe disability and/or neurological deficit. The goal of surgery is to shave it off and this has an 80%+ chance of improving his symptoms. The procedure wad describe in detail and the surgical video was shown. The risks include but are not limited to infection, bleeding, nerve root injury, dural tear, CSF leak, instability, recurrence of the disc (5%), DVT, PE, pneumonia, anesthetic risks, cardiac risks, stroke, death and other non specified risks. The patient had several insightful questions which were all answered to his satisfaction and consent obtained.
Second opinion from Dr George Hardas Consultant Chiropractor
The patient pursued chiropractic treatment to avoid surgery and came to Dr George Hardas Consultant Chiropractor and presented his condition. Dr Hardas has completed 6 levels of tertiary qualifications as well as 10 years of clinical research of the spine. This gave him the knowledge and ability to treat the patient, who as a result made a full recovery and completely avoided surgery.
The outcome for this patient was a full recovery of his presenting signs and symptoms by Dr George Hardas Consultant Chiropractor and a pain rating score of 0/10.