Case Report - Lumbar spinal herniated disk (Sciatica)

Tim H. Tanaka, Ph.D., D.AC, RMT, RNCP, BCIAC

 

This case summarizes the non-surgical recovery of a young female patient who was diagnosed with complete disk herniation and was recommended back surgery by three different back specialists.

 

SH is a 24-year-old female, who is an event coordinator. She presented to the Pacific Wellness Institute in December 2000 complaining of severe low back pain that radiated down to her right foot that started a year prior. She was also experiencing numbness and a tingling sensation in her right foot. The pain was so intense that she could only walk for 15-minute intervals. She consulted an orthopedic surgeon, and was diagnosed as having a "very large complex disk herniation in the right L4-5 region" based on CT scan and MRI results.  She consulted two other specialists both of whom confirmed the diagnosis and recommended back surgery.  Previously, she was seeing a chiropractor with no improvement of her symptoms.  She was taking anti- inflammatory medications that she was prescribed by one of the specialists to control some of the pain.  She was given one month time before proceeding for surgery.  She decided to visit an acupuncturist at The Pacific Wellness Institute upon her relative's referral.

 

On physical examination, only active flexion of the lumbar spine elicited pain. All other active ranges of motion were negative. The straight leg raise (SLR) test was positive only on the left side, with a 45-degree angle raise. The patellar and achilles tendon reflexes were intact.  There was no weakness of plantar flexion strength; however, she exhibited marked weakness in dorsiflexion of the left foot.

 

I suggested to her that she try acupuncture for a month and see if there is any improvement of her symptoms.  After several acupuncture treatments, she postponed surgery since her leg pain decreased significantly, and continued to receive weekly acupuncture treatments.

 

On March 2000, she had no complaint of any backache, leg pain or weakness, and no neurological signs remained other than ignorable mild numbness in her ankle region.  There was no restriction or pain during lumbar range of motions and SLR became negative.  She returned to work on a full-time basis.

 

Comments:

 

Most back specialists agree that at least 4 to 8 weeks of conservative approach should be tried first before surgical intervention is considered unless the patient is experiencing urinary or intestinal function abnormality or severe muscle weakness becomes present. 

 

In my experience, most disk herniations (neck and low back) improve without surgery by a specific acupuncture approach (systemic and local).  For the proper recovery from back pain, it is also important to avoid or minimize activities that lead to back injury, and physical (mechanical) and emotional stress. 

 

In this case, as of today (April 2003) SH is still pain free and enjoying normal life activity without any limitation.  She is still receiving acupuncture treatment once every few months to maintain her progress.

 

 

Ø      Read about Acupuncture Treatment for Low Back and Sciatic Pain