Patient has had progressive pain, numbness, and weakness in both lower extremities. He has had an epidural, physical therapy, and medications. It was reiterated that the patient has lost over 30 pounds. He has clear-cut instability as documented by the pars fracture and the spondylolisthesis, which is mobile on flexion/extension films.
This is a 42-year-old female with a 2/7/2015 date of injury. A specific mechanism of injury has not been described. DIAGNOSIS: low back pain; Lumbago with sciatica right side; Myalgia 12/01/15 follow-up visit identified lower back pain. Patient rates the pain as 7/10. The pain is characterized as burning.
All health providers describe neck strain radiating down his shoulder. He had physical therapy three times a week for 6 months but still experienced pain at the end of 2012 to the beginning of 2013 when his physical therapy ended. DHD referred him to Dr. Katzman who discussed the need of surgery to his left shoulder which he didn’t have because no fault cut him off. He also had an MRI of his cervical spine and
Review of systems is positive for heat/cold intolerance, skin rash, new growth or mole, snoring, ankle swelling, abdominal pain, nausea, muscle pain, muscle weakness and difficulty sleeping. As of this report, an 11-panel urine drug screen was administered on this visit and showed positive for oxycodone. Patient continues with failed back and radicular pain for several years and failing adjuvant and increasing tolerance. A second opinion was advised and proceed with surgery if needed, or a trial of spinal cord stimulator.
DOI: 08/29/2006. Patient is a 57-year-old male bookbinding operator/route salesman who sustained injury when he was startled by a cat while making a delivery and fell. Per OMNI, he was initially diagnosed with lumbar herniated disk. The patient is currently temporary totally disabled due to knee surgery in April 2013. Based on the progress report dated 03/21/16, the patient reports that his low back pain tweaked again, after making the bed.
QEP Scripts for Two Recordings – Audio for Musculoskeletal System; “OK, Team! We have a new patient in Room 3B who is being admitted with a progressive (gradual, advancing) decrease in mobility (movement) of his back and legs, and increase in pain located in the lumbosacral (lower back above the tailbone of the spine) area. The patient’s Primary Care Provider has sent along Computed Tomography scans (CT, a rotating x-ray emitter, detailed internal scanner) showing spinal stenosis (narrowing of the spine causing pressure on the nerves and spinal cord causing lower back pain.) and decrease of the normal lordosis (abnormal curvature lower spine, excessive inward curvature of the spine) in the thoracic vertebrae (upper and middle back). Lumbosacral
Client has pain when extending the neck towards the sternum, lateral extension of the right side, and reduced range of motion in rotation of the neck towards the left side of the body. Patient explains that prior to her injury she could touch her chin to her sternum area, easily rotate her head from right to left and look over her shoulder. She complains of lack of sleep due to pain, headaches, problems with driving and inability to bend neck to read, eat, and engage in office/school work. Client loves to take long drives, put together puzzles, and play video
Pain is aggravated by lifting and movement, and relieved by rest. Associated symptoms are decreased mobility, and joint instability and
Per procedure reports, the patient is status post therapeutic bilateral sacroiliac intra-articular injection on 02/18/16, diagnostic bilateral sacroiliac intra-articular injection on 02/05/16, confirmatory bilateral L3-5 medial branch nerve block on 01/25/16, diagnostic bilateral L3-5 medial branch nerve block on 01/11/16, bilateral L5-S1 transforaminal epidural injection on 04/06/15, bilateral L5 dorsal ramus
An MRI was performed of the lumbar spine. The examination found no significant extra
This article presents a case report about a 31 year old male patient, a teacher at a university, who started experiencing mid back pain after weightlifting one day.3 About 3 hours after weightlifting, the patient began to feel sharp back pain, at levels T4-T8. His pain began to worsen that night causing muscle spasms of his paraspinal muscles, with intermittent radiating pain to his lateral thorax and chest.3 This patient had been diagnosed with thoracic facet injuries in the past, and just assumed it was that.3 However, after the pain did not subside the patient went to his physician who claimed the patient was just having muscle spasms and needed myofascial release.3 However, a radiograph was also done that revealed end plate degenerative changes at T7-T8.3 The patients clinical evaluation revealed muscle spasms of the paraspinal muscles between T3-T12, tenderness to palpate between T6-T8, full shoulder ROM, 5/5 shoulder muscle strength, and normal distal pulses and sensations.3 The patient was diagnosed with thoracic pain and muscle spasms and was give muscle relaxants and exercises for myofascial release.3 Three days after the physician visit, the patient decided to do some walking, to work on his cardio, and experienced mild shortness of
Per medical report dated 06/16/2015 by Dr. Lemley, the patient complains of pain and dysfunction to bilateral hands/wrists. She has right greater than left discomfort in her thumbs with numbness. She states that cortisone injections do not help.
He has also recently received part of a series of synvisc injections, which have helped somewhat. He reports increased pain since last
DOI: 7/27/2011. Patient is a 53-year-old female jobber who sustained a work-related injury to her lower back while she was throwing away a bad batch of buns and she felt a pop in her low back, causing numbness in her leg which gave out. As per OMNI notes, the patient also fell to the floor. Urine drug screen obtained on 12/17/15 is negative for hydrocodone and is positive for nordiazepam, Diazepam, oxazepam, temazepam, cyclobenzaprine, methamphetamine, and ethyl sulfate. Based on the medical report dated 01/06/17, the patient continues with neck and low back pain. She had a fall last week when her back spasmed and ended up cutting her foot.
Clinically, there was no evidence of either cervical