ELDERLY MAN WITH PARKSINSON’S DISEASE REPORTED TO HAVE IMPROVED HIP ROM AND REDUCTION OF BUTTOCK PAIN AFTER CHIROPRACTIC CARE

68 yo male presenting with painful left foot and left buttock pain, referring sharp shooting pain down behind his legs up to his ankle. It started 20 years working as gardener, lots of bending down as part of the job. Since then, the pain comes and goes with pain score of 10/10 when it strikes. Love walking around the town but it has been affecting him due to pain. He was also diagnosed with Parkinson’s Disease on the same year and currently on Levodopa.

Had a massage, physiotherapy and acupuncture but nothing seems to relieve the pain permanently.

He came to the clinic as he wanted to continue being mobile and avoid surgery but pain is stopping him from doing so.

Orthopaedics Test done but it difficult to establish a baseline due to general stiffness so as muscle testing and deep tendon reflexes.

XRay taken of the whole spine and noticeable degeneration of the discs and the joints and lesser bone density. George line interrupted at L5/S1 indicating moderate translation of L5 vertebral body over S1. Right pelvis also higher than the Left of 18.65mm with moderate lateralisation of L4 and L5 towards the right.

Diagnosed him with Degenerative Joint and Disc Disease of Cervical, Thoracic and Lumbar Spine with anterolisthesis of L5/S1.

MANAGEMENT

  • Gentle whole spine manipulation (mini thrusts) over a period of 12 weeks. Including SI drops, sacral blocks, Cervical traction and lumbar distraction.
  • Rehab Exercises on Lumbopelvic region introduced on 5th As well as foot mobs with activator on the top of whole spinal manipulation.
  • Postural correction introduced (Denner Roll) on 5th
  • Soft Tissue manipulation introduced on 9th on the top of whole spinal manipulation.
  • Reassessments on 5th, 11th, 17th and 24th visits

OUTCOME

  • Noticeable spinal movement on palpation on every assessment and good motor control on legs.
  • On third week: reported to have good body control
  • Reported to enjoy weekly dance classes
  • Reported to have increased ROM on left leg
  • Re-XRayed on 24th visit and noted to have increased L pelvis approximately Vertebral Body of L2 and L3 shows rotational improvement towards the midline. Unfortunately, Lateral View of Lumbar spine shows no good picture quality to identify improvement of anterolisthesis.

DISCUSSION

Patient PA improved significantly in terms of good motor control on lower limbs despite of having Parkinson’s Disease as co-morbidity. Clinical data shows improvement and structural changes as seen on radiological findings.