[PhD Win medical case] lower back pain | 4 injections and one waiting injection | severe sharp lower back pain | auckland acupuncture clinic

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He has had lower back pain for 7 months, he had an MRI which shows the root of the nerve L5L4 is damaged by the disc. He did 4 sessions of steroid injection and one waiting injection, but he still more sharper pain in both lower back,  and the pain radiates down to both hamstrings, with no pain in both lower legs. a little bit of weakness in the lower back. He doesn’t want to do the 5th injection, his friend recommended me to him, try acupuncture.

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My opinions

1, What do we think about MRI results?

MRI shows left lumbar spine L4L5 disc Hernia， there are pain in the left lower back and leg, numbness in the left lower leg, and weakness in the left leg if it is a disc hernia, but for the case, lower back pain in both side, radiates to both thighs, he does not feel the left lower leg pain and numbness. I can not think it is a lumbar spine disc hernia. for example, if only a headache, let the patient do an MRI of the lumbar spine, we think the headache is due to the lumbar spine disc hernia if the MRI shows L5L4disc hernia. in the clinical, we can see many patients who do not feel symptoms, but the MRI shows a lumbar spine disc hernia.

2， Why don’t the practitioners do a general physical exam?

I will do a physical examination, especially the neurological exam. In this case, I found that the knee-tendon reflex is normal, and the straight leg raise test negative, but the areas of L1-L2, S3-S4 are not sharper. these examinations do not support the diagnosis of the lumbar disc hernia. why his practitioners do not do physical examinations?

3, What did I think of it from my general neurological examination?

there is only damage to the 3 cutaneous nerves ( superior gluteal cutaneous nerve, middle gluteal cutaneous nerve, Inferior gluteal cutaneous nerve, and femoral nerve cutaneous branch）from examination, he fell on the land, sprained the lower back muscle, muscle spasm damage the cutaneous nerves, the sharp pain in the lower back, 4 steroid injections are in the deep of lower back for the root of nerves, so the injections are unuseful.

4, what kind of ways is the acupuncture?

He had acupuncture twice, and 95% of the pain disappeared. His waist felt stronger and he walked normally. If it is a lumbar disc herniation, acupuncture should be ineffective, and even 4 injections of steroids show no improvement. So I thought it was a muscle injury, and then the cutaneous nerve was compressed. Acupuncture relaxes the muscles and then relaxes the compressed nerves, so the back pain disappears.

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