Friday, October 30, 2009

Time does not matter

I recently saw a patient with a one year history of pain into the right lower extremity below the knee which was becoming progressively worse. She had already had MRI’s, EMG studies, several injections and trials of medications without any lasting change in symptoms. Her subjective history and objective examination were somewhat puzzling. However, the one constant was that we could find a centralization that would centralize her leg pain. By the time she came for her second visit, she reported movement of her pain that had been present for over one year and reported intermittent right low back and buttock pain only. Within the next visit, this moved further into the back until all symptoms had abolished.

She has since been able to progress to recovery of flexion and resumed all functional activities without symptoms returning. Her only complaint was of how long it took to have this problem assessed correctly and that all the testing that was done was irrelevant to her problem.

The moral of the story is that centralization should be used as guide for all of us who evaluate low back and neck pain.

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