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
Surgical Options
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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

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What if the patient continues to have pain from the facet joints despite series of injections and chiropractic care?

  • Cervical Facet Radiofrequency Neurotomy