Arhived Issue - PRAKTIKOS
Autumn Equinox, 2006
Nothing venture, Nothing win
- W. S. Gilbert
Winning Health Back
As I stood before the treatment room door, I wondered how Laura had done on her three-week trip to Croatia, Venice, and a family reunion in Germany. It had promised to be a grueling adventure, full of long plane flights, that would require sleeping while sitting up, strange beds and bad pillows.
In fact, her first visit to our office had come after a Caribbean cruise. The demands of travel had increased her two year old neck pain so much that she could longer live with it. Luckily, Laura’s friend Carolyn had seen us for neck problems, and her description of our style of work sounded just what Laura was looking for.
Laura is an R.N. with seven specialties, ranging from asthma to oncology. Her husband is a much beloved M.D. internist with Kaiser. They were frustrated with her continuing problems but unwilling to subject her to any old-fashioned, high-velocity adjustments for fear it would only aggravate her pain. When Carolyn told them of our gentle style of low-velocity specific stretching and ultrasound to relax muscles, it seemed worth a try.
Laura really had tried everything else. She had been to physical therapy to do exercise; she had tried electrical stimulation and a TENS unit, and taken anti-inflammatory drugs. She had gotten massages, used ice, used heat, exercised with rubber bands, rested, walk daily, danced, changed her pillow, taken hot showers, and done aerobics—all to no avail. She was studying fine arts, but was on the verge of dropping out because she could not carry all the equipment needed.
When we talked that first day, she described a constellation of systems that centered around her neck and areas controlled by the nerves emanating from the neck. Her primary complaint was spasm and pain across the tops of her shoulders that were stronger on the right side. Her neck always felt tight and weak, and the pain became worse with any reading or studying (a real problem for a woman back in school working toward a degree in the fine arts). She reported her right forearm felt tight and full, and her right hand often fell asleep. Her right jaw felt full, swollen, tight, and restricted. For the past several months she experienced dull frontal headaches, as well. These symptoms actually increased while she was in bed trying to sleep, which left her tired and worn out.
Our examination needed to discover not only the source of her problems, but also why they started, as there was no history of car wrecks or trauma to the neck. We began by examining the pelvis and sacro-iliac (SI) joints because of their role as the foundation of the spine. Here we found a condition that might explain her problems: her right leg was nearly a half-inch shorter than her left because of a slip in the SI joints. Further questioning revealed that she had indeed suffered a hard bang to her coccyx (tailbone) when she was 11 years old, almost 30 years earlier. Her tailbone still hurt when she sat on it and she had a low-grade back pain, but they seemed insignificant when compared to the problems in her upper body.
The hit to her tailbone had knocked her pelvis out of alignment and over the years her body had compensated for the functionally shortened leg by building a scoliosis all the way up in her neck. Her neck-related symptoms had actually started while she was working as Kaiser’s nursing coordinator of outpatient asthma care. This job, which she held for four years, involved long hours on the phone and computer. She often cradled the phone between her shoulder and neck while she talked to a patient and typed.
Now we were getting somewhere! The long-term unleveling of her pelvis had created a twist and a weakening of her neck. The awkward positioning and continued misuse of her neck was the last straw. As her neck muscles got tighter and tighter, they began to inflame the neck joints. Soon this joint swelling and irritation began to aggravate the sensitive neck nerves, which spread the problem to the related muscle groups in the shoulder, arm, hand, and head.
We began the process of relieving her neck problem by blocking her pelvis. You who are patients know what that means, but for new people reading this, here is the process. Laura lay on her stomach, and we placed padded triangular wedges under her pelvis to provide a slow, gentle leverage to place the SI joints into their proper positions. By moving these joints, we were able to level her pelvis and equalize her leg lengths.
Once she was standing on a level foundation, we could begin to untwist her spine and relax her muscles. Using the same gentle process coupled with ultrasound, we straightened her spine from the low back into the upper back, which allowed the neck to respond to treatment.
All this time, Laura was actively involved in her own recovery. She was taught which positions to avoid and which to cultivate so as to avoid re-injury. She was instructed to continue to walk every day with an emphasized arm and shoulder swing. She was taught to ice her SI joints to speed their repair and to ice her right lower neck to begin reducing her nerve inflammation and resultant pain.
Laura worked hard. We worked hard. Progress in such a deeply rooted and long-standing problem was hard won. It was easy to regress. But we found we were winning! She began to sleep better and to hurt less. Her pelvic foundation leveled and stabilized. She discovered she did not have to give up her goal of becoming an artist, a fine artist.
That is why I stood outside her treatment room that day after her trip to Europe wondering how she had fared on such a long, difficult journey. As I opened the door, she lifted her head and turned it toward me. Her radiant smile said it all. She had done well, and we were winning. Oh, by the way, she had more good news: one of her pieces of art, a photograph, had been accepted into a juried exhibition and won Best of Show. She is a winner in more ways than one.