The first case involves a 55-year-old male with a history of recurring back pain. This patient has been treated for various problems in our office since 1977. The areas of complaint varied from neck, upper back, mid back, low back and various extremities. Most problems were related to occupation and recreation.
His occupation entailed standing for eight hours per day at a counter on the concrete warehouse floor. Much of the time he was lifting or bent over his work. Lifting in the day ranged from lifting light hardware to lifting extremely heavy products. He was employed at this job for approximately 25 years. Minor acute injuries accumulated over the years, and eventually developed into chronic recurring back pain. Over the past several years he has suffered from constant low-grade backache with recurring bouts of severe back pain.
This patient initially responded well to chiropractic care. However, over the years, his problems became more persistent and severe. The minor injuries began to take longer to heal. A gradual onset of chronic backache developed from occasional to constant, with frequent episodes of severe back pain. The episodes of severe back pain gradually became more frequent and more severe, with the development of occasional leg pain. Chiropractic visits became more frequent, and positive results more difficult to achieve.
Treatment has consisted of chiropractic adjustments, muscle relaxing techniques, exercises and therapy modalities. This proved quite successful until the last four years. At this time, there was a noticeable change, with an increase in visits and a poorer response to treatment. In January of 2002, it was suggested that he begin exercises on the gym ball and try to sit on it for 20 minutes each day. He did this for a short time and quit, because sitting on the ball for this long increased his back pain. His back problems had continued to increase in severity and frequency. X-ray examination 2003/03/20 revealed mild degenerative change at the level of L3–L4 L4–L5 with moderate disc space narrowing at L3–L4.
Re-examination of treatment protocols in the spring of 2005 revealed that he was not using the gym ball because it seemed to irritate his back. He stated that he could only sit on it for two minutes and it began to hurt his back. So he quit using the gym ball. Chiropractic treatment continued, and he was instructed to sit on the ball for 2 minutes or until it was uncomfortable and to increase the time he used the ball, as comfort dictated. At the end of eight weeks he was able to sit on the ball for 20 minutes.
The patient has been rewarded for his persistence with a considerable reduction in all symptoms. He experienced a reduction in the severity and frequency of episodes of back pain, and the sharp back pain and leg pain were completely gone. The constant backache gradually improved and is now not a problem. He now experiences only occasional low back discomfort and no severe back pain or leg pain. Patient office visits have been reduced to once per month or less ().
The graph () is a comparison of the number of office visits before and after the gradual reintroduction of the gym ball in May. The graph shows a reduction in the number of office visits after the gym ball was introduced on a regular basis.