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Sacral Pain after Fall

Exit forum ID Forum Discussion Sacral Pain after Fall

This topic contains 0 replies, has 1 voice, and was last updated by   Danielle Hommer, DC November 9, 2017 at 8:30 pm.

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    Danielle Hommer, DC

      I have a 34 year old female patient that slipped & fell directly on her tailbone onto the concrete at the pool with her kid in his arms in July. She visited her PCP who told her if it was a fracture, the treatment would be the same either way so she just waited it out. Got released from PCP to visit me on 10/10/17.

      Initial Visit: Pain is located in the middle of her tailbone just below LS junction. She reports pain as aching/throbbing 7/10 with sitting and a stabbing pain on sit to stand. Provocative includes sitting (for any amount of time – she stands whenever possible) and especially car rides where she feels the pain more in the area of L4. Palliatives includes standing (doesn’t report a limitation), seated on a donut pillow or lying down.

      R SLR: 82 degrees with mild post thigh stretch (-) DF
      L SLR: 88 degrees with mild post thight stretch (+) DF to calf

      R SHF: 2 fingers with mild stretching in right glute
      L SHF: 0 fingers with mild stretch in left glute

      SLPF: fingertips no sxs

      QLF: 11011 with mild-moderate SS ligament and sacral, Bilat L4/5 multifidus/longis adhesions.

      R KHE: 9″ mild anterior hip stretch
      L KHE: 10″ mild anterior hip stretch

      Current: In 5 sessions we have removed all IAR relevant adhesions above but patient is unable to tolerate MAR depth for treatment at every visit. After the 2nd treatment I ordered x-ray and after the 4th, an MRI.
      MRI results: L4-5 demonstrates very minimal left lateral disc bulge with annular tearing. (This radiologist is good, it is very subtle to my eyes!)
      She has went from slight extension 1-3″ to 0-4″ flat as of 5th tx with IAR but still unable to tolerate MAR. Subjectively she’s at 6/10 with throbbing/achiness located just above lumbosacral area and mentioned that she noticed some numbness for the first time the end of last week and that her ‘left knee felt funny’ (radicular symptoms from where the disc bulge).

      If she can’t tolerate MAR what is my next step?

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