Paesthesia In Lumbar Spine Dichotomy
DOI: 6/28/03. Patient is a 63-year old female who sustained a work related injury due to repetitive bending at the waist. The patient was subsequently diagnosed with low back pain, lumbago, and other intervertebral disc displacement of lumbar region. As per medical report dated 3/17/16, patient reports paresthesia in the right buttock and hip area and down the right leg into the calf during the evaluation of her work related injury in the past. She notes the onset of the current flare-up after riding in the car for an extended period of time and sitting for long periods. Objective findings during palpation revealed + 3 tenderness at L4 to S2, which is predominately on the right. Range of motion limited to 35/90 flexion, 15/30 extension, 3/20
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Based on the medical documents submitted and the specified treatment guidelines on the injured body part, the request for chiropractic visits with specific chiropractic adjustments for the lumbar spine is medically necessary.
The patient reports paresthesia in the right buttock and hip area and down the right leg into the calf during the evaluation of her work related injury in the past. She notes the onset of the current flare-up after riding in the car for an extended period of time and sitting for long periods. Objective findings during palpation revealed + 3 tenderness at L4 to S2, which is predominately on the right. Range of motion limited to 35/90 flexion, 15/30 extension, 3/20 lateral flexion, 10/20 right flexion and 15/45 rotation. Straight leg raise, Bechterews and Patrick Fabere test were positive on the right. Patient has had conservative chiropractic treatment for the injury in the past with positive results. A chiropractic adjustment, also known as chiropractic manipulation, manual manipulation, or spinal manipulation, is a common therapeutic treatment for lower back pain. As per ODG, it is recommended for chronic pain if caused by musculoskeletal conditions, only when manipulation is specifically recommended by the provider in the plan of care. It is manual therapy that moves a joint beyond the physiologic range-of-motion but
Based on the medical documents submitted and the specified treatment guidelines on the injured body part, the request for chiropractic visits with specific chiropractic adjustments for the lumbar spine is medically necessary.
The patient reports paresthesia in the right buttock and hip area and down the right leg into the calf during the evaluation of her work related injury in the past. She notes the onset of the current flare-up after riding in the car for an extended period of time and sitting for long periods. Objective findings during palpation revealed + 3 tenderness at L4 to S2, which is predominately on the right. Range of motion limited to 35/90 flexion, 15/30 extension, 3/20 lateral flexion, 10/20 right flexion and 15/45 rotation. Straight leg raise, Bechterews and Patrick Fabere test were positive on the right. Patient has had conservative chiropractic treatment for the injury in the past with positive results. A chiropractic adjustment, also known as chiropractic manipulation, manual manipulation, or spinal manipulation, is a common therapeutic treatment for lower back pain. As per ODG, it is recommended for chronic pain if caused by musculoskeletal conditions, only when manipulation is specifically recommended by the provider in the plan of care. It is manual therapy that moves a joint beyond the physiologic range-of-motion but