I have written this mini-case study based on a combination of individuals that I’ve seen and I’ve added some details which are typical of Lumbago.
The sections in bold outline are what I and my Chiropractic colleagues at Lushington Chiropractic would do as part of working up a guests case. Essentially with all our new guests we run through a triage assessment which consists of taking a medical history, carrying out an appropriate physical examination and if necessary x-rays in order to reach a diagnosis. We then take time to explain our findings and the potential care options to our guest.
Please also note I use the term “guest” instead of “patient” because I believe that customer care and a genuine personal touch is at the heart of all that I do. I appreciate the people I see are patients and I am responsible for their clinical care as I am their Doctor of Chiropractic. I never forget my clinical, ethical and moral responsibility to the people who see me. However, I also remember that the people who see me are people and not just a “case” or a “diagnosis”.
My typical new guest presented to Lushington Chiropractic with a 3 week history of low back pain which had come on after lifting heavy boxes at work. They also describe that they have been getting similar milder episode every 3 months for the past 10 years. Each episode had been lasting a little bit longer and had been more painful than the previous.
Over the past 3 weeks, the pain has been gradually worsening and is now becoming easier to trigger. Their pain is described as a constant 4/10 ache which worsens to an 8/10 with long periods of sitting, bending, lifting and twisting actions. The pain is relieved by gentle walking and lying down.
My initial new guest consultation at Lushington Chiropractic is an hour long appointment. In this time I aim to get to the root of the problem, find out whether Chiropractic treatment is the best course of treatment for you and what other alternatives may suit you.
During the consultation I find out a lot of information about; how, where and when the symptoms came on, if they’re worsening or getting better, what makes the symptoms better or worse. I also ask about illness, accidents or surgeries. It is important that I find out as much information about your condition and general health as possible to give me the best chance of making an appropriate diagnosis and management plan.
After I have taken the history and am happy that I’ve found out as much information as possible, I usually have a diagnosis in mind. However, an examination is still important to rule out more serious conditions whilst confirming your diagnosis.
During the examination, I start with looking at my guest’s posture. Quite often you’ll find clues about their problem when looking at how a person stands. Next, I will observe how the person is using this area of their spine, so will ask them to do a number of movements to see if there are any limitations.
Following this, I’ll ask the guest to take a seat and will perform a number of neuro-orthopaedic tests, these are objective tests which will help me to determine whether there’s any damage or injury in the area. An example of one of these tests is Kemps- this test helps to compress the joints in the low back. If they are injured this test will feel stiff and tender to the person.
I use pin prick sensation, vibration sensation, muscle strength and reflexes to help examine the nervous system, this enables me to see if there is a compromise in the nerve supply. All of these tests later on will allow me to have an objective marker to see how much improvements are being made with treatment.
At the end of the examination I will have a good idea of what your condition is. I will then give you a brief synopsis of my findings and will also explain what the next steps will be for you. If you decide to see me at Lushington then I hope you’ll feel welcome and cared for, as a guest of the practice.