Back Pain, Scoliosis, Physical Trauma

Nikki and her friend referred Patsy to me.  Patsy lives in another county and drives up to
see me.  She has back pain.  She has a lot of problems.  She was diagnosed with scoliosis
over a year ago.  The orthopedic MD told her that her >30 degree scoliosis would only get
worse and she did not want surgery.  Her other significant history was that she had some
serious physical abuse over 25years ago. On examination, I told her that she was hit on the
left ear and temple with an open hand and that there was a frontal face injury.  Did she fall
on the right side of her face?  No.  She was punched on the right side of her face.  All the
symptoms of tinnitus (ringing in the ears), dizziness, vertigo, headache and pain can be
explained and treated. She has been with me for over a year now.  Her pain is manageable.
She is not on any medications.  Her scoliosis is now 26 degrees, proven by xray. We are
currently working on her legs.  She has significant restriction of range of motion at her hips
and knees. Total visits so far:  17

It has been 10 months since I last saw Patsy.  She did something and twisted out her back.  
She has had back pain x 2months and it is not going away.  Even with this new pain, she
still does not take any meds.  Stretches and her usual exercise do not seem to help.  Total
visits so far: 22

I haven't seen Patsy for a year now.  She has had a mild headache in the last week.  She
and her family were on vacation.  Housekeeping accidentally threw out her nighttime bite
guard.  It was custom fitted for her over 20yrs ago after her facial injuries led to a
'dislocated jaw' that caused the joint to 'heal wrong.'  She had been dependent on it all this
time.  She was distraught and cried for a whole day, mourning the loss of the bite guard
and fearful of the migraines that were sure to follow.  They did come and lasted that first
week and finally subsided to lower grade headaches.  After 2months, they did not resolve
on their own and she could feel things 'shifting in her head.'  This one visit corrects and
resolve the headaches.  I have her follow-up in 1 wk just to make sure.  On follow-up, I
recheck everything.  The fixed scoliotic lumbar curve is much less severe.  The constant
chronic low back muscle tightness on one side is much softer.  Patsy notices that  she can
walk and stand for a longer period of time without feeling fatigued.  At the end of this visit,
her scoliosis changes and her R leg is noticeably shorter.  I send her home with exercises.  
We discuss the possibility of her needing a shoe lift.  This she will figure out on her own
keeping in mind my instructions for the changes we should expect.  She will decide when
she will come back.  In the future, perhaps 6months from now, I will order a repeat back
xray to recheck her scoliosis.  I believe that she will improve on her own by at least 5 more
degrees.