03/02/2021
very active, 62 yo male presented with a stooped, “old man” posture. He complained of severe reflux (GERD) and right-sided low back pain made worse with rightward bending-resulting in a painful, recurring “pop.”
Upon postural examination, his scoliosis (abnormal curvature of the spine) was evident. He couldn’t even lay flat comfortably—he needed several pillows to prop himself up. He had to sleep that way no less than 4 hours after eating to avoid reflux. He was able to bend to the left uninhibited but bending to the right resulted in a recurring “pop” and pain-limiting his full range of motion. I hypothesized that his reflux was at least partly due to the scoliosis and that the lowest rib was buckling under the superior rib, causing the painful “pop” whenever he bent to the right. To confirm my theory, I ordered lateral flexion and standing x-rays.
The x-ray report demonstrated a 25 degree rightward lumbar curve and confirmed my theory regarding the “buckling” of the 12 rib under the 11th on rightward bending. The x-ray also showed degenerative changes to the low back discs and joints-which helped explain the low back stiffness and general achiness. My treatment goals were to prevent progression of the spinal curve, minimize or eliminate the low back pain, and reduce his reflux. I judiciously employed chiropractic joint manipulation, therapeutic exercise, supplements, and lifestyle modifications. The patient has been extremely proactive since day one-which is the main reason for the success achieved despite infrequent visits:
On his 6th visit (9 mos later) pain was absent on right flexion “pop.” 15 mos since his first visit, the “pop” vanished and his reflux was significantly reduced. 2 yrs (11 visits) after I first met him, he is pain free. He stands straight naturally and lays down without needing pillows to prop himself up. His reflux is also significantly improved. I will see him again in 6 months for maintenance care.
I shared this story with a friend who knew of a similar situation in a young woman. In that case, the medical doctors removed the lower ribs to “fix” the problem. I suppose we all have health decisions to make. What would you do? ,