Case Study: Lyle Helke- 71 year old male Diagnosis: Trigeminal Neuralgia (pain in the face and head) Onset and History: Symptoms began 7-8 years ago for this 71 year old male. He went through several tests at local medical center without significant results or findings to determine a treatable diagnosis. He was referred to the dentist for possible Botox. The dentist recommended intramuscular trigger point release instead of Botox. Previous treatment: teeth pulled, Xrays, Nose surgery - pulp removed, double sinus surgery. Symptoms: Prior to coming to Burkhardt Physical Therapy Center, LLC the patient had constant pain in the left side of face, jaw, eye area, forehead, cheek bone and into nose and sinuses. Symptoms were eased temporarily by nasal saline washes but only a small change. He rated his best pain at a 7/10 and a worst pain at a 10/10 on the pain scale. Initial Function: Symptoms affected his sleep, daily routine, recreational and social activities. All activities were difficult to perform including eating and drinking. Occupation: semi-retired - painter (buildings) Initial Evaluation at Burkhardt Physical Therapy Center: 3-21-14 He demonstrated with forward head and shoulders, reduced cervical lordosis, scapular protraction; severe tightness and tenderness in the neck, shoulders, and face; and hypomobility in the cervical and thoracic spine. Strain Counterstrain screening indicated neuromuscular dysfunction of the fascial structures of the visceral, venous-lymphatic, arterial, neural, dural, cranial, and musculoskeletal systems. He demonstrated with 58% impairment on the Neck index. First treatment: 3-21-14 Fascial Counterstrain to the lymphatic, visceral, and nervous system including the bilateral thoracic/lymphatic duct, internal jugular vein, medial transverse cervical lymphatics, external jugular vein, Sibson’s fascia, tentorium cerebelli, trigeminal nerve I, II, II,temporal nerve, and facial nerve. Kinesio taping was applied to the left TMJ/masseters, over left nose and zygoma. Myofascial, diaphragm, and thoracic releases were performed. Patient and patients wife were instructed on how to apply Kinesio tape to the face for pain relief; was educated and issued information about Strain Counterstrain, Intramuscular Trigger Point Release, and Neck Saver Tips. Subsequent treatments: The following treatment sessions focused on decreasing remaining dysfunction through Fascial Strain Counterstrain of the dura, nervous, and lymphatic systems; Kinesio taping to the affected left side of the face; Therapeutic Exercise including inner core re-training, cervical mobility, and posture re-training; Instruction on proper bed mobility to decrease strain on the neck and face muscles; and Intramuscular trigger point release to the affected face, head, and neck muscles. Discharge: 6-18-14 The patient was seen 15 times from 3-21-14 to 6-18-14. During this time the patient experienced a significant improvement in function. His sleep improved 80%. Daily routine improved 80-90%. He now has minimal difficulty with eating and is able to eat popcorn, nuts, and cheese with ease 80% of the time. His worst pain is now a 2/10 and his best pain is a 0/10! He demonstrates with 26% impairment on the neck index which is a significant improvement. Patient testimonial: 8-10-14 About a year ago, I went to my regular dentist in La Crosse for my annual checkup. We were discussing my awful pain I always had in my face near my left nostril. I had double sinusitis surgery about five years ago. It stopped the pain for a while and then it returned. I was told it was Trigeminal Neuralgia. Since I refused surgery because of the medications I was on, my dentist told me to check with Chris Welch in West Salem at Waterloo Heights about Botox. We then went to a meeting with Mr. Welch. He told us about Burkhardt Therapy. He thought we should try this. So I went to Burkhardt Therapy and had 15 treatments of Strain Counterstrain and Dry Needling. It helped me so much as to relieving the pain and allowing me to sleep better and eat better. As it bothered me when chewing food too. I highly recommend Burkhardt Therapy to all who are having chronic pain, headaches, fibromyalgia, jaw pain, past surgical back pain, joint pain, vertigo, dizziness, sport injuries, etc. The people at Burkhardt Physical Therapy are very caring and they treat each person very good. Thanks to all of you who helped me to relieve my pain. If I need to return, I surely will and will spread the word about how it helped me. May God bless you all. Sincerely, Lyle Helke- Stoddard, WI Conclusion: This case study emphasizes the profound effect of utilizing a combination of techniques including Fascial Strain Counterstrain, Intramuscular Trigger Point Release (Dry Needling Technique), Therapeutic Exercise, Kinesio taping, Myofascial Release, and Patient Education to significantly reduce pain and symptoms. Despite the chronic nature and failed prior medical interventions this patient is doing very well with little to no pain. This patient responded very well to a team approach including a Physical Therapist and a Physical Therapist Assistant at Burkhardt Physical Therapy Center, LLC.
Posted on: Thu, 23 Oct 2014 18:37:14 +0000
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