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Case-Study 9

 

 
 
“K.S.” is a 52 year old, right-handed, male, millwright.

History:

“K.S.” presented with an approximate one year history of episodic neck pain (worse on the left side), tinnitus and intermittent loss of hearing. He also had a short-lived bout of blurred vision. He had pain in both shoulder joints. His major problem post-accident was in the low back. The accident caused an aggravation of pre-existing low back pain (especially on the left). He developed numbness in the left groin and problems with erection and urination (initiation and control). He noted tingling sensations in both legs. These symptoms dated from the motor vehicle accident on May 30, 2008.


Physical Examination:

Movements of the lumbar spine were significantly limited in forward flexion, extension, lateral rotation and tingling on the left. Palpation on the right side of the low back caused referred pain through to the left. He had numbness into the left groin and left leg. Movements of the head and neck were equally stiff and tight. Palpation of the muscles structures on the side of the neck and across the shoulders caused pain. There was no weakness or loss of sensation. An MRI of the lumbar spine revealed a minor prominence of the epidural fat at the lumbar spine, with minor facet joint osteoarthritic changes at L4/5 and mild to moderate changes at L5-S1 (greater on the left than on the right).


Previous Therapies:

  • Physiotherapy, chiropractic, facet joint blocks and acupuncture treatments were temporarily helpful in managing the pain.


Diagnosis:

The history and physical findings were consistent with mechanical pain.


Pulsed Signal Therapy (PST):

Lumbar spine

Pain Scale:


Before PST

Right after PST

6 weeks after PST

6 months after PST

Date of treatment

Jan 04 2010

Jan 14, 2010

March 01, 10

June 23, 2010

Intensity of pain

2

1

1

0

Frequency of pain

4

1

1

0

Rest. of Mov.

3

1

1

0

Swelling

0

0

0

0

Warming

0

0

0

0

Discolouring

0

0

0

0

Paresthesic

4

1

1

0

Explanation of ratings: 
0 = none or never
1 = slight or seldom
2 = moderate or sometimes
3 = severe or often
4 = extreme or always
NA= Not applicable


Daily Function Scale:


Before PST

Right after PST

6 weeks after PST

6 months after PST

Sleep

0

0

0

0

Standing

4

3

2

1

Sitting

4

3

2

1

Driving

3

2

0

0

Walking

3

2

0

0

Explanation of ratings: 
0 = six or more hours before the pain increases and disturbs function. 
1 = around 4 hours before the pain increases and disturbs function. 
2 = around 2 hours before the pain increases and disturbs function. 
3 = 20 min to 1 hour before the pain increases and disturbs function. 
4 = 5 min to 20 min before the pain increases and disturbs function. 
NA = not applicable


Conclusion:
  • Six months after PST, the pain intensity decreased 100%, the pain frequency decreased 100%, the paresthesia improved 100%, while the restriction of movement improved 100%


 

 

 
 
 
 
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