Client Case Study: Richard
Richard has been dealing with severe back back for just over a year and has a goal to be able to join his kids for a water polo tournament in Perth in January – a 5 hour flight that would have previously crippled him for a week.
Like most clients, he has been to see a handful of people before seeing me, all without actually getting some clear answers.
When he came in for the initial assessment he was on some strong opioid based pain killing medication, which were masking some of the feedback of the tests, but also giving him some interesting side-effects.
But along his journey so far, no one had actually taken the time to investigate WHY his pain was there; just thrown various medications a him to hide the pain.
We began with some provocation testing to investigate the causes of his pain.
He had some sensitivity to walking but his biggest aggravator by far was simply sitting.
Sitting would bring on an intense, burning, sciatic like pain in the back of his legs – more so in the left.
Adding flexion and compression did not affect the sciatic pain, but did increase pain sensitivity in his lower back.
We tested for compression sensitivity with a small 2kg/5lb DB and found that bracing the core would alleviate the pain in the lower back.
We tested extension and found that a disc recovery position would help relieve tension in the back and also help the sciatic like pain to settle.
From all of this I could understand his sciatic pain was not coming from an active disc bulge/facet joint/stenosis but rather a muscular issue around the hips.
Our first task was to limit aggravators by reducing and managing sitting positions and time as much as possible to let the sensitivity die down.
We could then introduce some key exercises to help rebuild core and hip function to take away workload from the lower back.
We are only 4 weeks in, but already Rich has improvement in posture, less pain and is now off of the opioid based pain killers.
We still have plenty of work to do, but he is well on his way to reaching his goal.
Online and in-person coaching available.