Anecdotal “evidence” that imagining is not always useful


Eval’d a 70 year old female, complaining of 4 month history of posterior-lateral L hip “burning” with sitting; driving is worst. 20 year history of left sided pain after lifting luggage into overhead compartment, but no recent trauma/infarct.

SLR (+), Slump (+), repeated flexion/extension (+)/(relieving), reflex testing (-), L lateral wt shift with L single leg stance, single leg sit-to-stand (unable L), lat length dec, lumbar extension with arm elevation, accessory breathing pattern
MRI taken a week ago but results were unknown.

Until yesterday. Minimal left sided lateral foramen narrowing at L5-S1 as well as minor 1mm lateral disc protrusion. Okay not “bad”. But then she goes on to say that her MD described her right side as “a wreck” (don’t get me started on catastrophizing). Between 2-5mm disc protrusions L3-S1 as well as facet arthropathy and moderate foramenal stenosis throughout.

Yet she notes NO pain on her right side. None, couldn’t even get a tingle. So her diagnostic imaging tells me that her right side is “a wreck” according to her MD, but she noted symptoms on her left. Once again, tissue damage doesn’t always equal pain and vice versa.

Always evolve,

Mike

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3 responses to “Anecdotal “evidence” that imagining is not always useful

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