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Case 9. Debilitating, jolting and blinding pain at the lower back.

Signs and Symptoms: Significantly sharp lower back pain at certain moments and constant deep achy pain otherwise.

Type of Trauma: Picking up an water bottle (~20 litre).

Adjustments: Specific force (Instrument or machine: No manual manipulation was involved) applied on the affected vertebrae.

Outcome: The lower back pain are resolved but the spinal stiffness sensation remains. The chronic neck issue is also resolved.

Early 60s female office worker who presented with severe lower back pain. She could barely take a few slow steps walking into the office due to the pain.

Any ranges of motion induced very sharp pain. X-ray was ordered and revealed the following.

This view is looking from the front. (called an AP; Anterior-Posterior view). In this view, the normal spine would show a straight line of vertebrae, not curved. Here is the example of the normal lumbar spine in an AP view.

Now go back to the patient's x-ray, notice there are multiple white spots over the spinal body particularly where the body weight is introduced onto. They are called "Sclerosis". It means an abnormal increase in density and hardening of bone. Also can be analysed as an ongoing arthritic state, which means "PAIN"

In order to resolve the lower back pain, understanding the mechanism of WHY such change and result is critical. From my clinical observation and experience, I found there is a correlation between the head position and the lower back pain prevalence. I observe numerous occasions where there is a dysfunction in the cervical lordosis, the cervical spine loses the ability to articulate therefore the cervical spine fixates. Once the cervical spine is fixated, the entire spine's motion is compromised therefore will impact negatively to the thoracic, lumbar and sacral spine. The most common clinical manifestation is the lower back pain.

No surprise, this patient also had the chronic neck issue. Cervical spine X-ray was ordered as well.

Notice the retrolisthesis of the C4 on C5. There is a spine mildly displaced backwardly to the point where it is encroaching to the space of the spinal canal, where the spinal cord is travelling. The facet joint of the affected level also shows a posterior (backward) directional facet misalignment. The cervical correction was added into the treatment plan. After 6 visits of treatment over the 3 weeks of period, the patient improved dramatically. The frequency and intensity of the pain decreased significantly. However, the stiffness and achy sensation flares up time to time which disappear after 24 hours. I believe the phenomenon is due to the spondylotic changes. (Limitation of the materialistic structure).

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