Case Study: 20 Years of Severe Back Pain and a Prayer

Case Study: 20 Years of Severe Back Pain and a Prayer Barefoot Rehabilitation Clinic

30 Oct Case Study: 20 Years of Severe Back Pain and a Prayer

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Have you lost time from your work and your life due to dealing with severe back pain?

One of our patients, Marilyn, did. In fact, those were her exact words.

When you’ve tried:

  • traditional chiropractic
  • epidurals
  • narcotic pain medications
  • muscle relaxants

And you’ve had:

  • MRIs
  • Cat Scans
  • X-rays

… That come back inconclusive according to the doctors who in charge of your care, you start to lose hope.

For some people, their last wish is a prayer to find an answer to the severe back pain that has debilitated them.

Is this you? If YES, keep reading.

Meet Our Patient Marilyn

marilyn-severe-back-painMarilyn is a 64 year-old grandmother-nurse-hustler.

Always taking care of others, Marilyn became annoyed by “9 out of 10”, severe, back pain that started to occur more often, occurring several times/week over the previous 6 months before treatment.

The pain was located in her mid-back on the left and it felt “knife-like.”

Nothing seemed to cause the pain and only pain medications gave her some relief.

As the doctor currently on the case, it’s my job to have the possible diagnosis in my head before I even start the exam.

When anyone says “9 out of 10” pain, that’s pretty severe. When the person in pain uses the word “spasm”, it’s commonly a disc problem.  With these two pieces of data, I’m immediately thinking:

9 out of 10 pain is NOT a muscle problem. It’s a probable thoracic disc.

While thoracic disc problems are rare, I asked Marilyn if she had an MRI in the past.  Thankfully, she had.

Marilyn’s Thoracic Spine MRI

In December, 2011, Marilyn had an MRI of the area.

It showed:

  • Mild arthritis (bone growth) in the lower thoracic spine.
  • T7-T8 bulging disc moving into the spinal canal without touching the spinal cord.

With this information, we confirmed that she had a structural problem (the bulging disc).

Then, it was time to do an exam and confirm the findings.

Marilyn’s Exam

Marilyn’s pain was NOT provoked by any neck motions. Even though her pain was near the shoulder blade (located at ‘B’ below) and she was restricted in the 5 neck tests, I ruled out her neck as the primary location of her problem.

Pain-in-Shoulder-BladeMarilyn’s mid-back motions were limited as well. The mid-back tests provoked her pain mildly, but not as intensely as it does when the pain flares up (confirming that a disc problem is a bigger issue than a possible muscle problem).

Her Thoracic Rotation was limited.

Her Thoracic Flexion was limited to two-3″ flat spots as evidenced by the most sophisticated (but helpful) tests in the entire world, The Pencil Test.

Below is the Pencil Test in action in someone’s low back.  The Percentage Function (as seen in the pictures) does not apply to the mid-back.  Notice the flatness against the pencil to the 3″ mark, then the light under the pencil starting at 3.25″.


When I pushed into the muscles next to her spine, I felt a moderate amount (not a minimal, but not significant either) of adhesion. A reputable expert in musculoskeletal care like Integrative Diagnosis providers can feel where and how much of this is present, then remove it.


With all of the information that Marilyn provided, including her:

  • History (how long she’s had the pain, her age, her injury and fitness history)
  • Symptoms (how intense the severe back pain was, what made the pain worse or better, whether the pain felt achey, burney, stabby, sharp, or numb)
  • Exam (her ranges of motion and the way her muscles felt)
  • MRI (the findings on the report) …

… I told her the Diagnosis.

  1. Mid-Back Disc Herniation
  2. Mid-Back Muscle Adhesion
  3. Mid-Back Muscle Weakness

Marilyn’s Treatment Plan

I explained to Marilyn that there was nothing we could do about her disc herniation directly. We could make her pain occur less frequently with less intensity and get better faster than before, but she would experience the pain again in the future. In fact, her disc herniation is guaranteed to get worse (like all degenerative bone, joint, and disc issues do). But, treatment could slow it down.

Over the next 4-8 treatments, we would remove all adhesion in her mid-back contributing to her severe back pain.

Here is what treatment looks like on someone’s forearm. Notice, her forearm muscle is shortened, then I stick my finger in her forearm and put tension on the muscles. Then, she lengthens the muscle, tearing out the adhesion.

After we removed the adhesion, we would strengthen the upper back so the muscles could handle the amount of work she did at home and at her nursing facility. The only muscle we gave her was the Good Morning exercise.


I’ll let Marilyn tell you how the treatment went.

Marilyn’s Story

Here’s Marilyn’s experience with us at Barefoot Rehab:

My name is Marilyn and I have had severe intermittent back pain for almost 20 years from which no one has been able to give me relief. Traditional chiropractic, epidurals, narcotic pain medications, muscle relaxants….nothing worked for long. No one even was able to pinpoint the cause. MRI’s, Cat Scans and X-rays all were inconclusive. I actually went to the emergency room several times due to excruciating pain. I was given pain meds and discharged. Got me through that moment but it was only a band-aid and never addressed the cause. My only recourse was to swallow some pills, go to sleep and hope the pain was gone when I woke up. I lost time from work and from my life dealing with pain.

My husband suggested I see Dr. Chris. For the first time someone actually knew what the problem was (adhesions) and offered real treatment. I have seen a consistent gradual reduction in symptoms in only a few weeks. Dr. Chris tells me there is every reason to believe that the condition can be completely resolved. And from the way I am feeling I believe it too. My only regret is not seeing Dr. Chris sooner!!

You Can Have Relief from Severe Back Pain Too!

Have you seen any of yourself in Marilyn’s story?

When you realize that another person was on the Medical Merry-Go-Round and found a way to get off it, hope rekindles out of the ashes.

You start looking for the best solution and even if it costs more per visit, you’ll be willing to spend your money because you realize that paying for a solution that works will save you money in your  wallet, time spent living pain-free, and happiness in the long run.


When you’re ready to see if relief is on the horizon for you, go ahead and do the Rotation Test and the Pencil Test to see if either of the tests provoke your pain or show limitations.

If you live in North Jersey and are ready to get out of pain, permanently, call us at Barefoot Rehab. 862-205-4847.

speechbubblesDo you have mid-back pain? What does your Thoracic Rotation look like? Feel free to share your symptoms and a video of your Thoracic Rotation below and we can discuss.


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Dr. Chris Stepien, DC, Full-Body ID Certified, ART Certified, CSCS, and CrossFit Level 1 Certified, fixes your annoying and frustrating pains, even when it's been over 6 months and you've seen 3-5 other doctors or therapists without lasting relief Barefoot Rehab in Denville, NJ. And when you're sad, depressed, or not enjoying life, Dr. Chris wants to hug you. He invites you to reach out, no matter what your concern is. Barefoot Rehab is here to serve you.
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