This time, I will discuss the physical examinations conducted for first-time patient at my practice, the progress of her treatment, and the changes in her pain levels.
Patient Overview:
A female patient in her 30s presented with lower back pain and left buttock pain lasting several days. She reported no pain in her lower limbs but experienced discomfort while sitting at the office and trouble sleeping, which affected her quality of rest.
The patient had been extremely busy recently, with long hours of desk work, and had been under significant stress due to relationship issues. In an effort to alleviate her symptoms, she started exercising at a sports club, but this worsened her condition, leading her to cease exercise before visiting my practice.
Initial Physical Examination:
The leg-raising test was negative, indicating no issues with nerve roots. The patient was able to stand on one leg for 5 seconds on the right and 8 seconds on the left. However, she could only hold a plank position on a training mat for a few seconds. This result highlighted a noticeable decrease in the strength of her quadriceps, hamstrings, and the inner muscles supporting her lower back.
Previously, her gym regimen had focused on power machine training rather than core-focused exercises like planking, which contributed to her surprise at the short duration she could maintain the pose.
Details of the First Treatment:
Initially, I assessed the mobility of the lumbar vertebrae and hip joints, noting general muscle tension. To address this, I applied shiatsu therapy and incorporated muscle massage and lymphatic massage to relax the muscles extending from the lower back to the buttocks.
I then utilized electrical acupuncture (pulse) on the lower back and buttocks, targeting areas with thick muscle layers to facilitate the relaxation of deeper muscles. Additionally, I performed stretching exercises for the hamstrings and calves.
The treatment session lasted 80 minutes and included acupuncture and manipulative treatment. We planned to monitor the patient's progress over the following week.
Details of the Second Treatment:
At the follow-up appointment one week later, the patient reported significant improvement. She indicated that her pain level had decreased from 10 to 5 and that she was now able to sleep soundly at night.
I observed muscle relaxation in the affected areas. Consequently, I administered the same manipulative conditioning treatment as during the initial visit and performed electrical acupuncture (pulse) to continue addressing the muscle tension.
Additionally, I used a foam roller to release the fascia on the outer thigh. The entire treatment session lasted 80 minutes, and we scheduled another follow-up to monitor progress in one week.
Details of the Third Treatment:
At the third treatment, the pain level decreased from 5 to 3. The patient’s appearance and walking style indicated a reduction in pain and muscle tension.
For this session, I used regular acupuncture instead of electric acupuncture, and moxibustion as requested by the patient. The patient dozed off during the treatment and appeared calm afterward.
With the pain having subsided, we will continue with regular maintenance and monitor the patient's condition.
Subsequent Developments:
Following the third treatment, the patient’s fear of pain gradually diminished, and she resumed her gym training. She now visits my practice bi-weekly, typically booking a 60-minute session, but opts for an 80-minute session when feeling particularly tired.
Given the significant pain reduction after the first treatment, I determined that the initial approach was effective and decided to replicate it for the second treatment.
If symptoms or pain persist without improvement, I will review and adjust the treatment plan as necessary. I believe that tailoring treatment to the patient’s specific pain, its severity, quality, and underlying cause is crucial for optimal results.
Despite a busy lifestyle and the challenge of finding time for self-care, I recommend addressing any pain or discomfort promptly. My goal is to help you achieve restful sleep and maintain a healthy lifestyle.
Daisuke Tazawa
BODYWORKS AZABU
*Permission has been granted by the patient to post the image and details of this treatment
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