Zero response to any treatment for LBP

Zero response to any treatment for LBP

Right side L5 - S1 Facet Joint Arthritis ( Bone Scan Study ) Nov 2011

Dear Dr Barry,

I have had back pain for 4 years. I originally hurt my back while I was sitting in my car and I turned to the left to get the road map and I overstretched and felt some pain in my lower back on the right side.

Since then to help get a diagnosis I have had

CT scan
Bone Scan Study ie: MRI with a contrast medium

All that that these scans could detect was some arthritis at L5-S1 facet joint on my right side.

I have seen the following therapists with no success.

3 different chiropractors 10 treatments or more for each one
3 different physiotherapists over 10 treatments
2 different Acupuncturists and TCM practitioner over 20 visits
Deep tissue massage therapist over 5 treatments
2 different Osteopaths over 10 treatments
Alexander Technique 8 visits
Bowen Therapy 4 visits

I have seen a Rheumatologist who gave me a cortisone injection into my right iliolumbar ligament which did not help. She said there was nothing else she could do for me and that I just needed to manage the pain with medication and exercise and modify my activity so as not to aggravate the pain

I have seen a neurologist who said my scans are really good and there is plenty of room for my nerve roots and disks all look really good. All he could for me was give me some nerve medication called Neurontin ( gabapentin )to help with the pain and to take pain medication if this Neurontin did not help. The was nothing else he said he could to for me.

I work at a Community Health Center and a new physiotherapist just last week had a look my back and said the following.

She did some range of motion tests and said that my lumbar spine moves as a block and that the lumbar vertebrae are sort of stuck and not moving freely in forward flexion. She said this causes my back to hinge above and below the below and might be the reason for my ongoing pain.

She gave me an exercise to help loosen up the lumbar spine to free it up so that each vertebrae moves freely on it own and is not stuck to other ones.

My Question:

Are there any exercises you could recommend that will help loosen up my lumbar vertebrae and help me with this on going pain?

I have been doing your back exercises twice a day for over 6 months and my back is still sore.

Also any other suggestions you could offer would be much appreciated.

I am going to a pain management clinic in the near future to see what they can do to help me with this back pain.

Sorry about the length of this inquiry I just wanted to give a good idea of what I have been going through.

Thankyou so much for your help

Yours sincerely

Nando Melbourne Australia.

Dear Nando,
Gosh you have been persistent and thorough. Well done, and it must be very distressing that you haven't responded to ANY treatment.

These are the kinds of thoughts that go would be going through my mind.

1. Firstly that this is unlikely to be anything serious in the sense of cancer and the like, but it is serious because it's seriously disrupting your life.

2. Secondly, is this a referred pain? The spine is notorious for what we call "incidental findings". That L5/S1 facet arthritis may be COMPLETELY irrelevant. It's there but not the cause of your pain.

One particular area to look at is the Thoraco-Lumbar junction. It is well known for referring pain to the buttock and sometimes groin. Read more at Maignes syndrome ...

3. Next, do you perhaps have a short leg? Sometimes a simple insert in the shoe can make a vast difference. The difficulty being how thick, and whether it should be under your heel, or the whole sole, or a shaped (and expensive) orthotic.

I do have different exercises, but if those haven't helped an iota, others probably won't either.

4. Often knowing exactly what provokes the pain, and what relieves it, a)helps you to understand what to do, and what not to do, and b)may give the clinician a different slant on your problem.

5. Could this be an inflammatory process? Look to your diet, and in particular the ratio of omega-6 / omega-3 in your diet. If it's high then one has general inflammation: muscles, joints, blood vessels, bowel.

I really commend you for being persistent. Don't give up. Press on...]

Go from Zero response to any treatment for LBP to Chiropractic Tips …

I hope this has contributed.

Dr Barrie Lewis

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