Successful Chiropractic and Rehabilitation Prevents Spinal Fusion Surgery for Chronic Low Back Pain: A Case Report

A 37-year-old female presented with low back and right leg pain that increased over a year despite interventions from a Chiropractor, Physical Therapist, Orthopedist, Pain Specialist, and Neurosurgeon. The patient failed medical management, local steroid injections, physical therapy, and had a very brief period of relief following surgical discectomy. She was considering spinal fusion surgery when she sought a second opinion. She described radiating pain that extended beyond the knee into the calf and ankle area latera and anterior as “sharp” and “twisted”. Treatment began with Chiropractic adjustments and soft tissue work using post-isometric relaxation (PIR) due to the amount of pain the patient was in and progressed from twice a week to weekly intervals using both passive therapy and active rehabilitation exercises. Using the Oswestry disability index (Fairbank JC, 2000), the patient progressed from a 62% disability “(crippled)” to 36% “(moderate disability)” during five weeks of in-office treatment, to 16% “(minimal disability)” during a 5 ½ week hiatus from in office care during which she continued at home active rehabilitation exercises. The goal of this report is to detail the importance of proper assessment and incorporating both passive and active care into a treatment plan. This report shows the effectiveness of a comprehensive history that leads to patient informed goal determination, in conjunction with examination, functional assessment, with the addition of active exercise to a passive treatment plan.