Abstract
Objective
To present a chiropractic treatment plan for a patient with lumbar disc herniation including radicular symptoms below the knee.
Clinical Features
A 38-year-old male experienced lumbar disc herniation with radicular symptoms to the lower extremities, below the knee. Etiology of this episode included a traumatic injury which was complicated by chronic degenerative joint and disc changes.
Intervention and Outcome
The treatment regime included chiropractic spinal manipulation, modalities and exercise rehabilitation. Specific rehabilitation exercises were used during various stages of healing in an attempt to stabilize a potential surgical case. Goals of care were to alleviate pain, increase function, and decrease peripheralization related to disc herniation in this case. The patient reached a level of functional biomechanical stability over 15 weeks.
Conclusion
This case demonstrates that with proper management, rehabilitation of a patient with disc herniation can be reached in a short duration of time.
Key Indexing Terms: Chiropractic; Rehabilitation, Low back pain; Intervertebral Disc
References
- 1.Manga P, Angus D, Papadopoulos C. The effectiveness and cost effectiveness of chiropractic management for lower back pain. Kenilworth Publishing; Richmond Hill, Ontario: 1993. [Google Scholar]
- 2.Stude DE. Spinal rehabilitation. Appleton & Lange; Stamford, CT: 1999. p. 64. [Google Scholar]
- 3.Johnson GS, Johnson VS. The application of the principles and procedures of PNF for the care of lumbar spinal instabilities. J Manipulative Physiol Ther. 2002;10(2):83–105. [Google Scholar]
- 4.Liebenson C. Rehabilitation of the spine: a practitioner's manual. Lippincott, Williams & Wilkins; Baltimore: 1996. pp. 293–315. [Google Scholar]
- 5.Erhard RE, Delitto A, Cibulka MT. Relative effectiveness of an extension program and a combined program of manipulation and flexion and extension exercises in patients with acute low back pain syndrome. Phys Ther. 1994;74:1093–1100. doi: 10.1093/ptj/74.12.1093. [DOI] [PubMed] [Google Scholar]
- 6.Lisi AJ. The centralization phenomenon in chiropractic spinal manipulation of discogenic low back pain and sciatica. J Manipulative Physiol Ther. 2001;24:596–602. doi: 10.1067/mmt.2001.118986. [DOI] [PubMed] [Google Scholar]
- 7.Schenk RJ, Jozefczyk C, Kopf A. A randomized trial comparing interventions in patients with lumbar posterior derangement. J Man Manipulative Ther. 2003;11:95–102. [Google Scholar]
- 8.Donelson R, Silva G, Murphy K. Centralization phenomenon. Its usefulness in evaluating and treating referred pain. Spine. 1990;15:211–213. [PubMed] [Google Scholar]