Apr 29 (edited) • CASE STUDY CORNER
Ideas? Odd response to treatment Case study
Hey Guys. I am a little stumped on this one. I just want to make sure that I am getting this right. I will hold off on my thoughts so not to scew anyone elses
46 YOA Truck driver with a history of Lx4-Lx5 Disc herniation.
Fell off a step of the truck 2/52 ago. More of a missed step into a drain. Didnt go down.
Getting pain on the R side in the back of the glut and down the Leg down into the back of the ankle and for the first time to the top of the foot.
On noproxen, codeine and panadole. painkillers seem to be the only thing that helps.
took on this morning at 7am.
Progressively gotten worse over that time. Tried to do stretches and knees to chest which didnt help it.
Findings.
Hip
Hip scour and quadrant test Positive B/L with the L side triggering the R.
No pain in the lower back. All in the top of the R glut down to the base of the glut
hip extensoin Lx driven B/L
Trigger points high in glut med
Lx
Standing posture large lean off to the R
Standing extensoin very limited
Flexion less limited
SB R feels it on the R, SB L okay
Very positive SLR on the R. Can barely lift the leg at all.
Rx
Responded really well to progressive passive extension, soft tissue, needling and cupping to lx and gluts. Zero pain on the table. Got up and was severely aggravated. Worse than when he walked in. Tried to calm it back down with very little success.
Earliest i could get him back in was the week after.
Similar result. walked in. responded well untill he got up but it was not too bad. Then when moving the R leg severe aggravation that would not calm down.
Thoughts? Am I missing something?
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Ideas? Odd response to treatment Case study
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