History
Catherine is a 39 yr old business consultant who injured her back when emptying the dishwasher in 2008. She has suffered 3 years of persistent right low back and right leg pain. The intensity of her pain was commonly 7/10 NRS and worsened by bending, sitting, home activities and gardening.
Catherine was able to flex to the knees only, when supporting her trunk weight with her hands. She had impulse pain but no neurological signs. Her range of lumbar extension was 50%. She was acutely tender to palpate over the low lumbar spine. Straight leg raise were bilaterally 80 degrees with no sensitisation.
Chiropractic manipulation and physiotherapy was of no lasting benefit. She was not considered a surgical candidate by her medical team.
Diagnosis
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Current Subjective History
Maria is a 47 year old, 178 cm tall, primary school teacher. She is fit and healthy, exercising regularly with walking and kayaking.
On Jan 10th 2012 Maria had an acute flare low back radiating bilaterally down the posterior of her legs as far as the heals. Maria was unable to sit and struggled to do the normal activities of daily living with pain levels at 7/10 NRS. Maria admitted to some ongoing low back pain issues over the 2 years, but this tended to be local and settled without needing any medical intervention.
Objective Examination
Maria had grossly restricted lumbar flexion, was acutely tender to palpate the low lumbar spine and had bilateral restriction of SLR to 60 degrees, which was positive to dorsiflexion sensitisation. Reflexes and muscle strength were normal.
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Background
SS presented to physiotherapy following a long history of fibromyalgia that affected her cervical, thoracic and lumbar spine areas with pain radiation into both arms and legs. SS had had various forms of treatment and commented that ‘hands on’ treatment aggravated her symptoms.
On Assessment
On assessment, SS had restricted range of motion in both her cervical and lumbar spine and symptoms of pain with a VAS of 8/10.
Treatment
Treatment chosen was the central placement of neuromagnetic devices to assess the effects on dampening central sensitization. One QF28-3 Q magnet was placed centrally over C4 and two QF20-3 devices were placed 2.5 cm each to the left and right of the C7 spinous process. There was an immediate improvement of cervical spine rotation from half range to full range right and left.
SS also reported pain in the lumbosacral area and a QF28-6 device was taped over the L4/5 intervertebral space centrally and two QF28-3 devices were placed bilaterally, one over each PSIS. Reassessment of her lumbar flexion after the application of the Q magnet devices saw SS with a 20° increase in lumbar flexion and decreased pain through range. The immediate improvement in symptoms indicated that this was an appropriate treatment.
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The dangers regarding overdose of prescription medications in the US is now becoming critical. According to the US Centers for Disease Control and Prevention, 27,000 people died from prescription drug overdose in 2007, a 5 fold increase since 1990 with the main culprit being pain medications.
Even the cosy relationship between medical schools and pharmaceutical companies is coming under closer scrutiny. The University of Wisconsin School of Medicine and Public Health which has been criticized for its advocacy of controversial uses of narcotic painkillers said it will no longer take money from the drug industry. The university had taken $2.5 million over a decade from companies that make opioids with a clear conflict of interest for their “independent” advocacy for the use of narcotic painkillers for chronic pain.
Meanwhile, ground-breaking therapies with little or no risk for patients such as neuromagnetics are practically ignored by doctors. Despite good evidence for this unique type of magnetic therapy, it still struggles for recognition. Principle physiotherapist Dianne Hermans has treated thousands of patients using quadrapolar magnets since 1999 with an 80% success rate, you can read some of the chronic pain case studies here. This supports the neurologist, Dr Robert Holcomb who pioneered this work with over 2,000 chronic and complex pain patients treated at the Vanderbilt University Medical Center in the 1990’s also with an 80% success rate.
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A growing challenge for the Australian health system is the growing cost of the Pharmaceutical Benefits Scheme (PBS) which subsidises the costs of approved drugs.
Rheumatoid arthritis is an autoimmune disease which causes chronic inflammation of the joints and as an example, the annual cost of these drugs to the Australian tax payer increased three-fold from about $46 million to almost $134 million between 2003 and 2007. Clearly this is unsustainable.
Lifestyle Therapies offers drug free treatments such as neuromagnetic therapy that can dramatically reduce the costs and the side effects on your body. In fact, this case study presented by principal physiotherapist, Dianne Hermans at an International Physiotherapy Conference showed a gradual decrease in pain medication of over $700 per year to almost nothing after a 20 year chronic pain history.
Reduction in cost of pain medication
Sam, a fifty year old man with a history of chronic lower back pain was referred to Lifestyle Therapies from a local health provider. Sam was initially referred for an electrotherapy called InterX, which is an advanced electrical nerve stimulator utilising skin conductivity. Sam had been suffering with constant deep pain and numbness in his right foot for 15 years, initially injuring his back when he was 20 years old. In his thirties, Sam underwent a laminectomy, followed by lumbar fusion of L5-S1 a few years later. Since then he has not lived a day without pain, significantly affecting his quality of life. In addition Sam was suffering hyperalgesia in his lower back due to an incident with a TENS machine. His skin in the lumbar spine was so sensitive, wearing clothes was unbearable which was an indication of Central Sensitization. He was unable to sit in a car for more than one hour without suffering significantly. Sam had one goal, which was to return to his hobby of painting.
Initial assessment findings:
- Muscle inhibition of core muscles
- High tones in gluteal muscles
- Tender to touch adductors, ITB, and Quadricep muscles.
- InterX readings were >100 at 2% intensity in the lumbar region with high sensitivity and pain, even with light touch; a sign of static mechanical allodynia.
InterX was used in the chronic setting for 15 minutes during the first visit. Immediately after, Sam was able to tolerate a 5 minute massage. He was also sent home wearing the OF50-3 Octapolar Q magnet, a breakthrough in magnetic therapy. This neuromagnetic device was selected since it’s large enough to cover the adjoining lumbar vertebrae L5,S1 and L4/5.
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Adrian presented for physiotherapy on the 8th June, 2010 and was interested in the Chronic, Complex and Repetitive Pain Therapy services on offer at Lifestyle Therapies.
Background
Adrian had complaints of upper back pain that he had suffered for more than 14 years. His symptoms had progressively worsened in the previous four years and recently became unbearable. He also had a history of a frozen shoulder that occurred 12 months ago. Adrian was emotionally frustrated having to deal with the pain for so long with minimal relief after seeing several different therapists, including an acupuncturist, physiotherapist, multiple chiropractors, rheumatologist and musculoskeletal doctor.
On Assessment
On assessment, the findings included:
• Muscle tightness especially in the Upper Trapezius, Rhomboids, Posterior Scalene muscles.
• Tender on palpation in the upper thoracic region with hyperactive trigger points.
• Poor posture
• and weak shoulder stabilisers.
It was determined that Adrian’s chronic pain had caused inhibition to muscle activation and increased muscle tightness which resulted in weakness and poor posture. Adrian’s goal for treatment were to decrease the symptoms frequency and to return to doing specific exercises and stretches that he has not be able to do in a long time.
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Case Study by physiotherapist Emma Gray B.Phty – May 2010
Sharon presented to me on the 28th April for physiotherapy after reading our website. She was quite interested in the chronic pain treatments that we offer at Lifestyle Therapies.
Sharon had a car accident in 2000 in which she fractured her left ankle. Since then she has developed lower back and upper back pain and her ankle was still very painful and limited in range.
Sharon has been in pain for 10years and has also been through multiple therapists and therapies and has depression.
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By Angela Bordignon – recent patient of Dianne Hermans.
I have had a disc issue for about 15 years, mainly concerning deterioration and a herniated disc at L5/S1, which I have managed very successfully via chiropractic treatment. Twelve months ago I started experiencing major spasms in my back, developed sciatica down one leg and had constant hipflexor tightness. After 8 months of weekly visits to my chiropractor we realised things weren’t getting any better so I had an MRI scan and was referred to a neurosurgeon in preparation for a potential disk operation to remove the herniation, which was causing my sciatica. At that point, I felt surgery might be my only option but wanted to try the chronic pain guaranteed service with Lifestyle Therapies before I committed to surgery. I now realise that if the symptoms aren’t subsiding after 12 weeks of consistent treatment, you probably need to try something else.
When I contacted Lifestyle Therapies and commenced the chronic pain guaranteed service, I was in chronic pain and discomfort daily (and had been for 8 months). I have always been a very active person but was at a stage where my disc issue was having a considerable effect on all areas of my life (physically, mentally and emotionally). I didn’t like to take pain killers, unless I was in crisis mode, as I found they caused more problems for my digestive system. I was unable to exercise other than walk slowly, was constantly stiff, couldn’t sit for any longer than 30 minutes at a time. I was becoming quite depressed and tied of trying not to be depressed!!
I felt Lifestyle Therapies offered a wide range of services which seemed to cover all areas of health in relation to my situation and I felt I would be in good hands. I found the team very friendly and the environment very relaxing. The initial evaluation was very thorough compared to anything I had experienced before. After a lengthy assessment, massage and ultra sound, they taped two Q magnets to specific areas of my body to alleviate the pain caused by my pinched sciatic nerve. It was also suggested I may have issues with iliopsoas muscles. I was provided some reading material and after reading this, I fully believe this has been a major contributing factor to my issue. I left with more hope of a recovery than I’d felt in a long time.
My expectations around Q magnet therapy were positive as I believe you should keep an open mind to new treatments. I had a lot of questions though and the team at Lifestyle Therapies have always taken the time to explain the issue in layman’s terms not to mention been very honest. Two weeks following my first visit my pain and muscle spasms had subsidised. Then following weekly appointments for approximately 4-5 months I am now completely pain free and have finally removed my beloved Q magnet and feel amazing.
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