I just recently returned from a trip to Israel as some of you may have heard. While I was there I had the pleasure of visiting the pain management department in the Haifa hospital – one of the truly integrative and progressive rehab departments I have seen. They have fully integrated many of the non-surgical and physical rehabilitation techniques that I have personally been interested in and had great success with.
Chiropractic, accupuncture and manual therapies are used quite often. In fact, they have on staff chiropractors that treat chronic and non-responsive pain on a daily basis.
One of the most exciting new technologies that I have been working with is known as the ATM2 or Active Therapeutic Movements. The concepts is great and the results are even more phenomenal than I expected. It’s based on the CNS (central nervous system) and how it governs, controls and activates muscle patterns. To learn more about this now you can simply follow this link on ATM2 or check out www.backproject.com since how this modality works isn’t the main focus of this post.
While I was there I had the pleasure of being asked to evaluate a post-operative patient that hadn’t fully resolved after surgery as well as after having many weeks of post-operative rehabilitation.
The patient was a 60 yr. old male who underwent L4/L5 laminectomy and spinal decompression surgery for spinal stenosis and disc herniation that was causing bilaterlly symptoms of sciatica as well as foot drop in the left foot. Post surgery back pain and sciatic symptoms had resolved until about 8 months out when mild sciatica like symptoms had returned as well as some subtle foot drop and muscles weakness.
My exam findings were consistent with the above mentioned symptoms. The patient was also experiencing numbness on the the soles of his feet and MRI revealed significant post-operative scarring at L4/L5 surgical site.
Since I didn’t have my usual equipment with me I had to improvise. After a thorough bio-mechanical evaluation I found that the patient had significant torsion in his pelvis and was able to clear that out with a manual adjustment using side posture technique. I always like to start by correcting the structural bio-mechanics first and then go from there.
Since I didn’t have access to the ATM2 I used a manual technique that provides similar benefit, although the patient was supine, rather then standing which isn’t optimal but still can provide significant benefit. First, I had the patient raise both legs while lying on his back and there was significant exacerbation of his symptoms with pain in the low back. While compressing his pelvis manually at the ASIS I had him repeat the previous maneuver and there was no exacerbation of symptoms and almost a complete reduction of pain in the low back.
I then applied increased amount of fource to the pelvis loading almost all my body weight onto his ASIS (you must be extremely careful with this procedure and please don’t try this if you don’t know what you’re doing) and had him once again repeat the procedure. This time it was pain free – essential to restoration of normal neuromuscular function.
I had the patient do just a single set of 10 repetitions like this and retested. His pain was markedly reduced and the numbness in his leg had reduced, although the bottoms of his feet hadn’t changed much.
Upon follow up and a two more treatment I’m happy to report that this patient is now 90% improved and the practitioners now have specific instruction for treatment that he may follow.
As of today, after receiving a phone call from Israel, the patient is now 100% pain free and functional. I can’t tell you how grateful I am for having had this opportunity and what a great experience it has been to be involved with such open and willing practitioners.
My thanks goes out not just to them but also to the patient who was kind enough to let me evaluate him.
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