OBJECTIVE: This case report describes the effect of exercise-based chiropractic treatment on chronic and intractable low back pain complicated by lumbar disk extrusion. CLINICAL FEATURES: A 47-year-old male firefighter experienced chronic, unresponsive low back pain. Pre- and posttreatment outcome analysis was performed on numeric (0-10) pain scale, functional rating index, and the low back pain Oswestry data. Secondary outcome assessments included a 1-rep maximum leg press, balancing times, push-ups and sit-ups the patient performed in 60 seconds, and radiographic analysis. INTERVENTION AND OUTCOME: The patient was treated with Pettibon manipulative and rehabilitative techniques. At 4 weeks, spinal decompression therapy was incorporated. After 12 weeks of treatment, the patient's self-reported numeric pain scale had reduced from 6 to 1. There was also overall improvement in muscular strength, balance times, self-rated functional status, low back Oswestry scores, and lumbar lordosis using pre- and posttreatment radiographic information. CONCLUSION: Comprehensive, exercise-based chiropractic management may contribute to an improvement of physical fitness and to restoration of function, and may be a protective factor for low back injury. This case suggests promising interventions with otherwise intractable low back pain using a multimodal chiropractic approach that includes isometric strengthening, neuromuscular reeducation, and lumbar spinal decompression therapy.

J Chiropr Med. 2008 Dec;7(4):146-54. Schwab MJ. Private practice, Schwab Chiropractic Clinic, Eau Claire, WI 54701.

by Joe Rubino, PhD

Research points to the fact that each child suffers an early assault to his or her self-esteem at a young age, typically between birth and 6 years of age. The child's initial realization that he or she is imperfect and somehow does not measure up, is flawed, or is not worthy of love, happiness, rich relationships, abundance, and fulfillment comes as a result of this early traumatic episode when the child either buys into the disparaging view of another or creates an interpretation that he or she is defective in some important way, even though no such conclusion was offered or intended by another.

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