![]() ![]() When asked to point to the pain currently, the patient pointed to her left hip rather than her low back even though her intake form indicated she was experiencing low back pain.Īuthors’ note: It is for this reason that it is very important to ask a patient to point to the exact place on his or her body that he or she feels the pain, especially in cases of low back or hip pain, since patients often confuse the two in terms of anatomical location. She was prescribed anti-inflammatory and analgesic medications (Tylenol) and discharged. When asked about any treatment sought while away, she indicated that she attended the regional general hospital and was told that, since she was able to ambulate normally, she was most likely experiencing a lower back sprain/strain injury, she did not require an x-ray. She immediately felt a severe sharp pain in the area of her left lower back, left hip, lateral thigh and lateral leg. During a decent down a flight of stairs she slipped and fell and landed on her left side. The patient explained that she had been visiting her daughter and her son-in-law and had returned to her home ten days ago. Her pain was initially attributed to uncomplicated mechanical spinal pain but was ultimately diagnosed as a hip fracture.Ī pleasant fifty-four-year-old Caucasian female presented to a chiropractic clinic with a chief complaint of acute left-sided lower back and left lower extremity pain following a fall down a set of stairs. This case study chronicles the assessment and management of a 54-year-old woman who presented with low back, hip and lower limb pain subsequent to a fall. ![]() 12 This necessitates a practitioner use a broad range of clinical tools in order to identify patients who are best suited to receive manual care (soft tissue therapy, mobilization, manipulation). 10, 11 Because of this, although the NBCE analysis reported fracture was ‘rarely’ encountered (0.9/4) in private practice (see 3), a field practitioner must still be vigilant to the possibility that a seemingly uncomplicated mechanical pain may actually be a much more serious condition, such as fracture, especially if the etiology is traumatic in nature. 10 The risk of a fall resulting in a serious injury rises proportionately with a person’s age, with older persons more likely to suffer a significant injury subsequent to fall compared with a younger person. One out of every three community dwelling seniors fall once a year, 7, 8, 9 and this number approaches 50% for those persons over the age of 80 years. Among the most common conditions preferentially affecting older persons is injury and disability subsequent to a fall. ![]() 4, 5, 6 This predictable and rapid aging of the population has significant implications to field practitioners as it will greatly influence the proportional frequency of those clinical conditions that preferentially affect older patients encountered in private practice. 3 Moreover, according to these studies, the average chiropractic patients were young to middle age adults, although the demographic group most likely to seek chiropractic care was the Baby Boomers, 1, 2, 3 a cohort group who are aging rapidly and causing a profound alteration to traditional pyramid-shaped population pyramids. 3 Additionally, extremity subluxation/joint dysfunction (3.2/4) and sprain of any joint (3.1/4) were commonly seen. 1, 2 The National Board of Chiropractic Examiners (NBCE) reported similar data, with ‘subluxation/ joint dysfunction’ being the condition most routinely seen in practice (3.9 on a scale of 0–4, with 4 being most commonly seen). Based on recent demographic data, two out of three patients who initially present to a chiropractor have either back pain (41–44%) or neck pain (24–25%). It is very common for patients to present to a chiropractor’s office with a chief complaint of spinal pain or disability. ![]()
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