The DPPP-SAA treatment protocol was continued for a total of 10 sessions every other day, and a re-evaluation was performed within 4 weeks following the last session. This patient continued to improve clinically up to 80% at the time of release.
SLR was negative, and Lumbo-sacral ROM within normal limits.
The only discomfort which had remained was a limited left gluteal pain following standing from a seated position, which was also self-limited and improved with time.
This patient was also advised on 4 stages of the exercise program beginning with light hydro-therapy, nuero-plastisity exercises, range of motion and indurative exercises.
The patient was scheduled for a re-evaluation in two weeks, and a follow up MRI study was also requested.
However, a pre-scheduled appointment was missed. The patient did report back within 16 weeks of the initial treatment session with a complaint of lower back pain exacerbation following an intensive exercise program. Even so all the neurological examinations were within normal limits, nevertheless it was decided to obtain a follow-up MRI study.
The follow-up MRI study was obtained 13 weeks following the initial pre-treatment MRI study, results of which can be seen here (plates 5-8/8).
The MRI comparative study indicated significant improvement of the IVD structural pathology fully consistent with the patient’s clinical presentation.
This patient was therefore advised to avoid heavy strenuous exercises, such as running on hard surfaces, for at least 10 more weeks and, was scheduled for a re-examination within 8 weeks.
