Opso Summer 2014
The Lower Extremity OPSO Summer Primary Care CME Conference August 15, 2014 K. Turner Slicho, DO Case Presentation 53-year-old Caucasian female complains of left sided SI pain described as an ache w/o radiation Initial onset of pain was 25 years ago, when her back “seized up” bending over to put her toddler to bed. Infrequent issues over the next 10-15 years, then began to be more problematic Now, constant pain over the last 2 years Numbness in a small area of left shin. Denies weakness, tingling Case Presentation Unable to sit for long periods, bend over, cross legs comfortably Does not lift her grandson Does not brush teeth bending over without holding the sink No longer exercising due to pain 15 chiropractic session with two different providers over 2 years with “absolutely zero effect” on her pain 12 physical therapy sessions with marginal effect Case Presentation PMHx: Unremarkable** FHx: Cancer, DM, Food Allergies, Meniere’s Disease, Restless leg syndrome, Ulcerative colitis PSHx: C-section 1990, Appendectomy 2009, Hernia repair 2005 Meds: Diclofenac 100mg BID Case Presentation X-Ray: L4-L5 degenerative changes. Normal pelvis and SI joints bilaterally MRI: mild degenerative changes L3-S1 without significant neuroforaminal or spinal stenosis Neurosurgical evaluation : non-surgical back Case Presentation Gen: NAD, A&O x 3 Neuro: 2+/4 DTR’s, Strength 5/5, no motor deficits, mild sensory loss in left superio-lateral shin Extremities: no edema, ecchymosis, peripheral pulses normal Case Presentation: Somatic Dysfunction findings Cervical: Left posterior OA facet restriction Lumbar: L5 ERSl, left iliolumbar ligament hypertonicity, mild left psoas spasm and left erector spinae m.
[Show full text]