1-Patient Story Series

I have decided in the new year, 2026, I will start to share clinical stories

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All of this will be anonymous and with the usual disclaimers.

You know the drill- no diagnosis, no treatment recommendations, no medical advice of any kind. Consult your own doctor. Don't just trust someone writing case stories on the internet!

I will attempt to give a simplified understanding my thinking process to help provide some sort of logical framework on how we get clarity with patients and what they need to attain greater health.

THE SIMPLE IDEA

The patient has the answers.

The doctor just needs better questions.

THE CASE

For our first clinical story we will start with something simple- back pain.

Hang on! I know what you are thinking, "A chiropractor talking about back pain? Lame. I'm done!"

But trust me. I wouldn't write about some lame thing like simple low back pain and how chiropractic can help.

'You should know me better than that. ;-P

But first some Stats!

• 80% of adults will experience low back pain at some point in their lives.

• Currently, 31 million Americans are suffering with low back pain.

• Low back pain is one of the leading causes of disability worldwide.

• Annual health care costs related to low back pain is over $100 billion.

• You are more likely to have low back pain if you are older, obese, and sedentary.

AND alot of the times, doctors get the cause or diagnosis WRONG.

Jane

Jane came in with a diagnosis of disc herniation.

She had low back pain with tingling and pain into the lower leg for a couple years.

She went to see the normal people- her family doctor, who sent her to PT, then some massage, and some acupuncture. All with limited degrees of success.

So, her family doc ordered an MRI.

Low and behold, there was a disc herniation at L4/L5 and so she was diagnosed with a disc herniation and it was determined, BY THE TEST, that was the cause of her suffering.

Back to the PT, massage, etc. but this time, they had a DIAGNOSIS. So, for sure they would sort it out, right?

Wrong.

Months later, no improvement.

She couldn't sit without pain and she also had a hard time bending forward without creating the pain down her leg. Classic signs of a disc herniation.

So, why wasn't she getting better?

Fact- 20-50% of people have MRI studies that show a disc herniation but have NO symptoms.

Fact- people think that the classic sign of a disc herniation related pain syndrome is sharp shooting pain down the leg (which is true), but a true nerve impingement is determined because the affected leg will get smaller.

Poor nerve function means no muscle activation and hence, your calf gets SMALLER.

Jane, may have had an MRI that showed a disc herniation, and some pain going down the leg, but she had NO change in calf musculature. Hence, NOT related to disc herniation.

Next, nobody bothered to ask her how this pain started?

Disc herniations require a trauma. You have to injure the disc with a fall, or lifting something super heavy, or a severe twisting movement to tear a disc. She had no such injury.

In fact, when I asked her, she said it gradually came on but she thought maybe it started not too long after she started hiking. No injuries.

Clue #1- pain with sitting started at her butt and went down, NOT at her calf as would be typical of a disc.

Clue #2- no injury and gradual pain that may have been related to hiking.

Clue #3- none of the "standard" treatment plans had worked.

QUESTIONS

Does the pain seem to get worse when going up or down stairs?

Yes, upstairs.

Does it hurt when you hike? If so, is it worse going uphill or downhill?

Yes, uphill.

What about when you Run? Long walks?

She doesn't run but it seems to get a little better when I walk. If she walks too long, then it will get worse.

Does the pain get better at all over the course of the day?

Sometimes. But yes, it's worse in the morning upon waking and gets somewhat better when she moves around.

I THINK HE's GOT IT

Hamstring strain.

As you can see, the hamstring muscle connects from your "sits" bone, or ischial tuberosity, and then to the lower leg of your knee.

FACTORS THAT SUPPORT THIS DIAGNOSIS:

• The attachment of the hamstrings to your "sits" bone.

• The action of the muscle as part of the "posterior chain" that helps push you up inclines.

• Connecting the activity, hiking, to the cause of initial injury. Remember Jane told us she thought it may be related to this.

• The lack of muscle loss in the calf.

• Pain improved with some movement - indicative of muscle issue rather than nerve issue.

• Standard treatment for disc was ineffective.

• Sitting made the pain worse.

WHAT NOW?

So after a thorough examination, it was pretty obvious that it was a hamstring strain.

If, I was right, the first treatment (chiropractic adjustment, muscle release and reset techniques, and gentle activation of the muscle) would result in immediate improvement.

After I finished, I asked her to sit and then stand and bend forward and see if anything had improved.

She was amazed.

After a couple years of suffering, there was finally some improvement in her pain.

She was excited but also upset that everyone had gotten it wrong.

THE LESSON

First, listen to the patient.

Jane told me that she thought it may have been related to her hiking,

Since, the hamstring is responsible for driving the leg uphill, it made sense. She probably overdid it and just didn't realize it. She just kept hiking on an injured hamstring until her body finally quit.

Second, ask better questions.

I needed clarity not just test results. Studies show up to 50% of MRI studies show a disc herniation with no symptoms. I have heard that more than 90% of us have a disc herniation that can be seen on MRI whether you have symptoms or not. Don't assume the test is always better than good old fashioned talking.

Be a detective and gather clues.

Third, know your physiology!

What is the clinical proof of a disc herniation (nerve impingement)?

What is the anatomy of structures in the area of complaint?

What are the possible causes of the problem?

What is the origin and insertion of the muscles in the region and nerves that control them?

CONCLUSION

Jane was in treatment with us for a total of about 8-12 visits.

The total time to resolve a hamstring strain is usually about 8 weeks.

Treatment protocol was chiropractic adjustments to normalize and improve nervous system function, muscle release and reset, stabilization exercises, isometric exercises to strengthen the hamstrings tendon, then gradually more strengthening and ballistic exercises for her lower extremities.

She is back on the mountains hiking like a champ and has not had any set backs.

YOUR TAKE AWAYS

Hopefully, I gave you some food for thought and some tips for any health care people out there.

If you have back pain, think about these 3 things:

1. Did I have an obvious injury that is related to it? Or did it just slowly show up?

2. Did I eat something late at night or something that made me bloated? (this may be the next episode).

3. What is the expectation of improvement? Your doctor or provider should be able to give you an estimate, e.g. "after so many visits, I expect 60% improvement in your pain." Use that as a metric for success and if it's not happening, tell them to re-assess. Maybe they are missing something.

Please share this content with anyone you think may benefit.

Our goal is to get 100K people following us and actively working towards optimal health.

FDA DISCLAIMERNone of the statements on this web site have been evaluated by the FDA.Furthermore, none of the statements on this web site should be construed as dispensing medical advice, nor making claims regarding the cure of disease.  You, the individual, must listen to your body and use common sense to avoid injury.You should consult a licensed health care professional before starting any supplement, dietary, or exercise program, especially if you are pregnant or have any pre-existing injuries or medical conditions.These statements have not been evaluated by the Food and Drug Administration.These products are not intended to diagnose, treat, cure, or prevent any diseases.

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1.Liu YZ, Wang YX, Jiang CL. Inflammation: The Common Pathway of Stress-Related Diseases. Front Hum Neurosci. 2017 Jun 20;11:316. doi: 10.3389/fnhum.2017.00316. PMID: 28676747; PMCID: PMC5476783.