Dear Sood,
I find this case very interesting and also the approach you have
taken thus far. It will be interesting to see what comments the
list has.
Can you please explain what SGIS is for me.
Thanks,
Scott Epsley.
--
On Fri, 10 Dec 1999 10:55:43 Sood wrote:
>Dear friends,
> I examined a case of severe back-pain one week back at her residence ,
>Even making a small attempt to move was extremely painful for her.Before consulting me She was under the treatment of some other doctor who had put her on the bed rest with constant lumbar traction for a period of two months
>.Brief History:
>She had undergone leproscopy to seek the cause of vague abdominal pain under spinal anesthesia.After few days she felt lumbar gen.back painwhich latter migrated to her left leg.
>Her ESR was highly raised upto 140/1hr.MRI has shown Annulus tear of L4/L5 disc.
>I started her treatment with sustained extension in lying , by positioning her in extension with the help of few pillow under her chest. The pain centralised after the first very day ,When I examined her in standing position.she had lat.shift which was corrected SGIS ,I put her on SGIS with sustained Ext.in lying.and EIS.
> Now she has no pain in standing ,sitting or walking ,what is most
>frustrating is she is in severe agony when she tries to get up from supine position.As there is no shift I have stopped SGIS.She is still not able to do EIL.She is only doing Sustained Extension
>and EIS.
>What could be the cause for her difficulty in rising from bed.?---could it be loss of muscle tone due to prolonged recumbence /traction?Could it be SIJ too involved in addition to Spine.
>Could it be that her back 's soft tissue congested that it does not cause powerful enough contraction to cause take off of body weight from the bed.Heating with moist heat and gentle message makes her symptoms worst,cooling with ice helps.Now she is having maximum painful
>area is above left iliac crest ,with mild local tenderness.
>FIL is painful ,and cause gen. lumbar pain.FIS peripheralises pain.Coughing/sneezing doesn't effect pain .
>What could be done to help her get up from the bed without pain ?
>
>Dr.Sarveshwar Sood
>Orthopaedic Surgeon & Head Department of Physical
>Medicine & Rehabilitation,
>Member American Academy Of Pain Management.
>S.B.L.S.Hospital
>812/1,Housing Board Colony
>Model Town,Jalandhar city
>Punjab State.India
>E-mail [log in to unmask]
>http:/Personal.vsnl.com/sarvesh
>
>
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