LD is a 36 year old female with 8 years of lower back and buttock pain.  Prior to seeing us, she had a lumbar fusion, months of physical therapy, and several epidural steroid injections.  When she came to The Centeno-Schultz Clinic, we injected both sacroiliac joints and did some trigger point injections as well. She reported significant pain relief. We then started prolotherapy.  Today she had a major reduction in pain and has regained full range of motion.

Gerald was prepared to have a two level fusion for foot drop after getting independent opinions for both and orthopedic spine surgeon and a neurosurgeon.  He had his blood drawn and a preoperation physical and even went to pre-op back orientation.  Dr. Centeno decided to hit him hard with three times three level transforaminal epidurals in 3 weeks.  He now has his leg function returning, his low back pain is much less.  He's cancelled the surgery with the orthopedic surgeon stating that he no longer needs the surgery.

Gerald is back to his normal life.  He has returned to his activities and is happily recommending The Centeno-Schultz Clinic to everyone he knows.

Low back pain that never seems to completely subside. Started back around eight years ago when I started cutting hair for a living. Massage and Chiropractic treatments only relieved the pain temporarily.

Result:
Following two rounds of IMS (Intramuscular Stimulation): IMS (Intramuscular Stimulation) the pain is at worst a nuisance. Standing is still a problem from time to time, but nothing like it was only a few months ago.

What did the Centeno Clinic do to help this patient?:
Two rounds of IMS (six sessions each)

Duration of pain:
Approaching eight years.

Severity of pain:
Ranged in intensity anywhere from 0-1/10 up to 7-8/10 VAS

Brief summary of the patients pain and history, and subjective description:
Patient relates of on and off pain for the last seven to eight years. Previous care included Chiropractic spinal adjustments, ultrasound and massage. All resulting in minimal and temporary relief at best. The pain for the most part was described by the patient as being very deep and dull in nature.

Description of the Centeno Clinic findings:
Multiple lower thoracic and lumbar paraspinal trigger points, limited and painful trunk extension.

Previous Diagnosis(es):
Lumbago, low back sprain/strain.

Centeno Clinic Treatments:
IMS

Centeno Clinic Diagnosis(es):
Lumbar neuromyofascial pain syndrome

After 2nd accident lots of ongoing lumbar neuromyofascial pain since 2000, with most recent MRIs showing spidural fibrosis status, post laminectomy on the right L5-S1, moderate degenerative changes at those levels and L5-S1 potrusion.

Result:
Patient noticed her pain decrease.

What did the Centeno Clinic do to help this patient?:
2 transforaminal

Duration of pain:
4 years

Severity of pain:
10/10

Brief summary of the patients pain and history, and subjective description:
Patient had been in 2 car accidents and had several epidurals with no results. 2nd accident was more severe. Was seen by lots of different providers with no results and was being treated with severe depression because she was afraid to leave home. She was on SSRI antidepressants. Pain remained high until she came to our clinic . Patient noticed her pain decrease.

Description of the Centeno Clinic findings:
Hyperesthesia on the right C2 and C3 with hypoesthesia on the right at C4. Hyperesthesia on the right at C5 and in the ulnar region. Positive first rib TOS test on the left w/reflection to the upper extremity. Negative on the right. Rule out lumbar facet syndrome. Thoracic outlet syndrome on the right.

Previous Diagnosis(es):
Depression /bursitis.

Centeno Clinic Treatments:
Lumbar 5 and S1; Radio Frequency L4 & S1; 3 Medial Branch Blocks and 1 discogram L5/S1 regions/28 IMS / 4 NMS/24 MCU/PILATES 36X/Massage therapy X12.

Centeno Clinic Diagnosis(es):
Lumbar neuromyofascial pain w/recent MRI showing epidural fibrosis L5S1. Neuromyofacial Pain: Neuromyofacial Pain SI Joint: SI Joint

Patient presented approximately 6 weeks ago with 10/10 low back pain. Had been driving sister 2+ hours/day to doctor's appointments over the last few months and "my low back just got worse and worse". Patient had previous neck pain treated to resolution in the past at the Centeno Clinic with IMS so returned to see if we could help again.

Result:
Back pain was resolved "no pain at all." in 6 treatments.

What did the Centeno Clinic do to help this patient?:
6 IMS (Intramuscular Stimulation) treatmentsand some prescribed muscle relaxers.

Duration of pain:
1-2 months previous to her appt. here and "getting worse by the day"

Severity of pain:
Pain was 9-10/10 per her VAS form.

Brief summary of the patients pain and history, and subjective description:
Pain was present 1-2 months previous to her appointment here and just got worse. Pain was 9-10/10.

Description of the Centeno Clinic findings:
Decreased thorocolumbar ROM, mildly positive SLR, dermatone asymmetries to pinwheel, motorbanding/trigger point activity in thoracolumbar paraspinals/QL/posterior hip girdles along with hypertonicity and some spontaneous spasm with ROM exams.

Previous Diagnosis(es):
Previous diagnosis was cervical neuromyofascial pain syndrome.

Centeno Clinic Treatments:
6 IMS visits and muscle relaxers.

Centeno Clinic Diagnosis(es):
Lumbar neuromyofascial pain syndrome and mild exacerbation of cervical neuromyofascial pain syndrome.

Patient is a 42 year old male involved in a rear impact collision in 2002. He reported both neck and low back pain the day after the accident. He reported having no similar problems prior to the accicient. He reported not being able to participate in his normal recreational activities, especially dirt bike riding.

Result:
100% decrease in pain and disability.

What did the Centeno Clinic do to help this patient?:
Patient had 3 IMS sessions.

Duration of pain:
20 months

Severity of pain:
1/10-4/10

Brief summary of the patients pain and treatment history:
Patient say a chriropractor for 150+ visits with temporary relief. He also received acupuncture, which flared him up, and physical therapy which he found helpful.

Description of the Centeno Clinic findings and diagnosis:
Limited cervical and lumbar range of motion 10-15%. Motorbanding and tightness throughout the cervical and lumbar paravertebral musculature. Tenderness over the biceps tendon. Normal straight leg raising. 1. Cervical neuromyofascial pain, with facet involvement, most notably at the upper levels of C3 and C4. 2. Mild left biceps tendonitis. 3. Left wrist pain, secondary to sprain or an overuse syndrome, and he does note this came on after he had started a new job requiring different kinds of activities to which he was accustomed. 4. Lumbar neuromyofascial pain, with facet involvement, most likely on the right side.

Previous Diagnosis(es):
Cervical and Lumbar Strain

Centeno Clinic Treatments:
IMS

Back pain started with snow shoveling and escalated to 9/10 at worst with significant difficultly walking and performing activities of daily living. Patient was an avid runner and is unable to even jog.

Result:
Patient was able to run a marathon with no exacerbation of symptoms.

What did the Centeno Clinic do to help this patient?:
Transforaminal epidural steroid injections, IMS, and Pilates.

Duration of pain:
Injury occurred one month prior to initial evaluation.

Severity of pain:
9/10

Brief summary of the patients pain and history, and subjective description:
Athlete, comes in April with guarded gait, pain 9/10, cannot walk, localized in her lumbar region with radiation on the posterior and lateral aspect of her right leg. Standing is impossible and cannot do her activities of daily living.

Description of the Centeno Clinic findings:
20 degrees straight leg raises, positive. Dorsiflexion positive and lumbar radiculopathy. MRI positive for degeneratvie disc disease with disc bulges at L2-3, 3-4, and 4-5.

Previous Diagnosis(es):
None

Centeno Clinic Treatments:
Transforaminal epidural steroid injections, IMS, and Pilates.

Centeno Clinic Diagnosis(es):
Acute lumbar radiculopathy.

Results:
Low back pain gone!

What did the Centeno Clinic do to help this patient?
IMS (Intramuscular Stimulation), 6 Treatments Total.

How long did the patient have this pain?
2.5 years

How severe was the pain?
Severe

Brief summary of the patients pain and history, and subjective description:
Left lower back pain with pain radiating into the left leg and little toe. The leg pain began after L5/S1 disc ectomy. Calf became atrophied. Now sore in bilateral left and right hips.

Description of the Centeno Clinic findings:
Abnormal JPE test with upper cervical motor banding and atrophy of the C2-C3 muscles on MRI.

Previous Diagnosis:
N/A

Centeno Diagnosis:
Lumbar neuromyofascial pain syndrome .

Three car accidents resulted in constant headaches, back pain, numbness in my left arm and sciatic pain in my legs.

Result:
The Centeno Clinic along with Paradigm physical therapy saved my life! I felt the way I did before the first car accident in 2001.

What did the Centeno Clinic do to help this patient?:
Zanaflex 2 mg. for sleep and muscle relaxation. Six (Intramuscular Stimulation): IMS (Intramuscular Stimulation) Instruction on the neuromotor stimulator and MCU (Multiple Cervical Unit) Strengthening exercises as her home program.

Duration of pain:
3 years

Severity of pain:
4/10 usually, 10/10 at its worst, made worst by all types of movements as well as tension. Pain relieved somewhat by sleep.

Brief summary of the patients pain and history, and subjective description:
Three motor vehicle accidents since 2001. After third accident she had arm pain (cramping-type). Pt is dizzy especially when turning the head. She had a fall with injury to her knee and ankle but was resolved. She has concentration problems. Low back pain is localized in the mid buttock region. Pain radiates into groin and down the legs. Patient has been seeing a chiropractor as well as a physical therapist.

Description of the Centeno Clinic findings:
Intradiscal tenderness at the L5-SI spaces. There is posterior tenderness at C3 and C4. There is tenderness in the left SI joint on palpation. Motor banding noted in the cervical area and piriformis and gluteus medius regions. Pain is present with lateral bending. Spurling's exam produces some facet-type pain on the right. There is lumbar pain only on end range of extension.

Previous Diagnosis(es):
Severe whiplash injury with TMJ diagnosed by a chiropractor.

Centeno Clinic Treatments:
Six IMS treatments, Neuromotor stimulator and the Multicervical unit.

Centeno Clinic Diagnosis(es):
Cervical Neuromyofascial pain, Cervical facet syndrome, left sacroiliitis, lumbar neuromyofascial pain with facet involvement.