Daily Archives: June 23, 2017

Patient Consultation

November 4, 2016

I think that this case best demonstrates what Laser Therapy can accomplish. It truly has unlimited potential and once again this patient is typical of what can be achieved. Needless to say, nothing can be accomplished if you don’t attempt to change the therapeutic approach.

CLINICAL HISTORY: The patient is a female student and a competitive swimmer who sustained a severe contusion injury of the left foot in March of this year. She was diagnosed with complex regional pain syndrome and she now has extreme sensitivity to touch, extending to socks and shoes. She is unable to walk without a pneumatic boot, which holds the lower extremity in a rigid position involving the terminal portion of the left lower extremity.

She has seen multiple specialists including orthopedic surgeons, neurologists and is attending the Regional Pain Management Clinic at Sick Children’s Hospital in Toronto.

Since March, she has been on gabapentin, pregabalin, acupuncture, TENS, physio, massage, chiropractic, etc. She has received no benefit from these therapies.
Pain and generalized discomfort in the left foot and the lower portion of the leg is present 24/7. It is accompanied by a pins and needles sensation, numbness, and excruciating pain on any contact. She is a competitive swimmer, but now is unable to swim at all and even walking is problematic.

PHYSICAL EXAMINATION:

  • The patient holds the left leg below the knee in a fairly rigid position.
  • The right mid-calf is 32 cm in circumference and the left mid-calf is 30 cm.
  • There is marked atrophy of the calf muscles and the small muscles of the left foot. (Photographs taken).
  • Range of motion of the left knee is within normal limits, but also enhances the pain. Range of motion of left ankle is zero.
  • She is unable to dorsiflex, plantar flex, invert or evert the foot, even 1 mm.
  • There is extreme hypersensitivity from a point approximately 3-4 inches above the ankle including the entire foot and toes.

IMPRESSION: Regional Pain Syndrome — Left Foot (Secondary to Trauma.

DISCUSSION:The cause of symptoms could be located anywhere from the cerebral hemispheres to the spinal cord or locally in the left lower extremity. The fact that no improvement has been accomplished with many therapies, the patient’s outlook at this point is bleak indeed.

Some thoughts on this problem: It would appear that the nature of this problem is local, but also involving the neurological system. At some point, the motor nerves to the lower limb have turned off, which brings into play the parasympathetic nervous system.

Therapy must include BioFlex Laser Treatment of local tissue damage in addition to the neurological source including the spinal cord and parasympathetic nervous system. Treatment will therefore be applied locally and over the lumbar spine where the ganglia of the sympathetic nervous system are located.

Summary
Over the course of March to October, approximately 8 months in duration, the patient had extensive visits with a number of- medical specialists, underwent radiological and other studies, and utilized approximately seven different medications along with physiotherapy, etc. She was studied extensively at a University Children’s Hospital and was reviewed by several teams of specialists.
The cost of these therapies were in the $10,000 range and did not improve her status.

At our Laser Rehabilitation Center, she had treatments of the lumbar spine and the extremity involved on a Sunday, Monday and Tuesday. At this point, her symptoms were resolved over 90%. Over the next 2-3 weeks, she received some additional therapy with a complete resolution of all symptoms.

The patient has been able to resume her swimming as previously and is functioning in a normal manner in all respects. There has been no recurrence.
it should be noted that at Meditech, we treat at least one patient daily with what her mother has termed as “a miracle”.