Jon presented to our clinic on recommendation from a family member after having suffered with years of chronic lower back pain. He had seen seen numerous therapists over the years many of whom had told him his hips / pelvis were “out of alignment”. However, manipulation (clicking) to realign his spine was delivering ever decreasing results and he had got to the point where is was no longer helping a constant ache in his lower back as well as spasms and episodes of his back “locking up” which were becoming more and more frequent.
Jon did not have shootings pains down his legs and clinical signs did not indicate any “trapped nerves” (radiculopathy). Despite this we suspected Jon was suffering from one or two degenerative discs in lower spine. He had never been for an MRI scan, so this seemed the obvious thing to do in such a longer term problem, so we could have “a look under the bonnet” in order to fully assess Jon’s problem. His MRI scan came back reporting:
“…Extensive Modic type 1 change L5-S1.Lower three motion segments show facet OA. Left paracentral annular tear L4-5 and right paracentral annular tear L5-S1. (No significant nerve root impingement)”.
In addition, on review of the images scans we noticed slight signs of instability (dynamic retrolisthesis) of his L5 vertebra.
This correlated exactly with the clinical palpatory findings of (relatively) hypermobile L4/5 and L5/S1 segments with a very stiff / rigid spine at higher segments i.e. all Jon’s movement stress is occurring through his L4/5 and L5/S1, hence the changes seen on MRI and perpetual irritation of his lower most discs.
For the first time in a long while Jon experienced significant symptomatic relief from IDD Therapy (in fact from his very first session). The IDD helped to open up his compressed and inflamed discs. In addition we used dry needling (medical acupuncture) to ease the reactive tension and spasm Jon’s deep spinal muscles, near the worn discs.
We explained to Jon that in his case it was not a good idea to keep having his back “clicked”, at least not in the area of the worn discs. Whilst this may had the potential to produced reflex relaxation of the local muscles, and so afford him some temporary respite in his pain, this was unlikely to provide a long term fix. Worse still it actually had the potential perpetuate and make his situation worse as repeated manipulation (joint clicking) would likely make his ligaments even more lax, thereby making his his degenerative discs even more unstable.
We instructed Jon on the need for him to improve muscular stabilisation (core and multifidus etc.) specifically in his lower most segments and to improve mobility higher up in his spine.
Jon has show great improvement since starting treatment with us, we are now in the process of referring him to a specialist centre for target prolotherapy injections to help toughen the ligaments his his lower back. And we are looking into referring him for PRP treatment to help the healing process in his discs and (facet) joints.
To see our short video on a brief run through of Jon’s MRI scan click the picture below: