Severe Thoracic Spine Pain in a New Patient

I was off last week, trying to squeeze in a few vacation days, but ended up seeing an emergency patient who was desperate for some alternatives. He is a young man, 25, with chronic back pain on Methadone, Vicodin and Valium. He is able to work at his desk job in spite of the pain and medications, but landed in the Emergency Room on 8.8.11 at 2:00 a.m. due to out of control, severe, 10 out of 10 thoracic back pain. They gave him some Dilaudid and he made it home, but called me “in extremis” and so I agreed to see him.

(Brief primer: LFR/HFR stands for Low Frequency/High Frequency HRV. If this decreases, it is interpreted to mean that the stress response in decreased. So decrease in LFR/HFR=decreased stress. The other measure SD1/Sd2, is a nonlinear method, if this ratio increases =decreased stress.)

He was tearful and shakey , and was extremely tender to the touch in a swath 8″ wide from T9 to L1. He appeared to have some muscle spasm from inspection and light palpation. I did an acupuncture treatment that was aimed at general pain reduction and to decrease his stress response. I also treated the spine above the level of the pain, since that can sometimes affect the lower area without aggravation. I did some moxa on the affected area. I also monitored his HSoRV after needle placement. The initial trend is pictured above. The LFR/HFR from the 60-360 second versus the 360 to 660 segment were .96 to 1.18, which does not show a stress response reduction. But his nonlinear analysis shows an increase in his SD1/SD2 from .23 to .41, which is significant and his Sample Entropy increased from 1.23 to 1.63 which is definitely positive and suggestive of a decrease in his stress response.

When he returned to clinic on 8.11.11 his pain level was a 5 out of 10 and had been able to sleep, finally, after his treatment on the 8th.

This is how his LFR/HFR looked on 8.11.11. A more dramatic decline than on the previous run, but similar. His numbers were

LFR/HFR .23 for the 60 to 360 segment, and .16 for the 360 to 660 segment. SD1/SD2 were .5 to .65 respectively. Sample entropy unchanged 1.59 to 1.62. So we’ll how he did clinically when I see him today.