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CASE REPORTS
Case Reports is a regularly featured column meant to highlight the clinical applications of alternative or integrative therapies as they are implemented in patient care. Preference will he given to cases in which diagnosis, treatment, and outcomes are clearly defined.
A healthy 28-year-old female presented with an 8year history of chronic, midthoracic back pain. The patient's first episode occurred in 1986 after she was involved in a motor vehicle crash. At that time .She was treated conservatively with nonsteroidal anti-inflammatory drugs and rest. The pain resolved and she was pain-free for approximately 6 months. In 1987 the patient reinjured her thoracic back while working as a nurse. Since that episode and before she presented at the ALTMED clinic, the patient had been in chronic, debilitating pain and unable to work. Prior to the second incident of thoracic back pain, the patient was physically active, participating in sports and various fitness programs. She also had I child.
Over a period of 12 months, the patient aggressively sought relief from the pain. She was evaluated by 3 orthopedic physicians and a pain specialist. Multiple radiographs and a magnetic resonance imaging scan of her thoracic spine were negative. The diagnosis ranged from simple back strain to chronic ligamentous inflammation to fibromyalgia. Medications and bed rest, traction, transcutaneous electrical nerve stimulation, 3 separate physical therapy trials (which made the back pain worse), chiropractic manipulation, and acupuncture all failed to alleviate the pain. No procedure resulted in any significant relief and, as noted, some made the pain worse. Secondary gain was ruled out as a contributing factor.
The patient described her back pain as a deep ache between spinal nerves T8 and T10. She also experienced severe muscle spasms that were exacerbated by standing or sitting for any period longer than 15 minutes. The pain would often radiate around the back to the lateral chest wall bilaterally, but not beyond the midaxillary line. The patient complained of chronic fatigue...