Archiwum Przypadki - Goczewski

Chronic back pain after a car crash

Marcin Goczewski — Sun, 22 Aug 2021 11:15:50 +0000

Patient’s history

The middle-aged patient has been suffering from a strong lower back pain since a car accident that took place six months earlier. The pain restricted mobility and interfered with normal functioning. MRI examination did not show any tissue injury and bone damage.

Previous treatment

Rehabilitation and anti-inflammatory drugs gave only mild temporary relief.

Treatment form Dr.Goczewski

During ultrasound examination it turned out that the pain focused on superior cluneal nerve passing through the osteofibrous tunnel formed by the thoraco-lumbar fascia and the iliac crest . It is a common site of a nerve entrapment. Hydrodissection of a superior cluneal nerve and thoraco-lumbar fascia was done.

Outcome

The pain disappeared within a few days.

Artykuł Chronic back pain after a car crash pochodzi z serwisu Goczewski.

Pseudo sciatica due to piriformis muscle hypertrophy

Marcin Goczewski — Sun, 22 Aug 2021 11:05:33 +0000

Pseudo sciatica due to piriformis muscle hypertrophy

Patient’s history

The middle-aged patient has been suffering from buttock pain for four years. The pain restricted mobility and interfered with normal functioning. MRI examination of lumbar spine did not show any abnormality.

Previous treatment

Patient was treated with anti-inflammatory pills, injections and rehabilitation without any long term improvement.

Treatment form Dr. Goczewski

During an ultrasound examination piriformis muscle hypertrophy was noticed and the piriformis muscle syndrome was diagnosed. Under ultrasound guidance piriformis muscle prolotherapy and sciatic nerve hydrodissection was performed. The symptoms disappeared.

Outcome

The patient returned to a sport activity.

Artykuł Pseudo sciatica due to piriformis muscle hypertrophy pochodzi z serwisu Goczewski.

Diabetic neuropathy resistant to treatment

Marcin Goczewski — Sun, 22 Aug 2021 10:59:08 +0000

Diabetic neuropathy resistant to treatment

Patient’s history

Elderly patient has been suffering from diabetes for many years with accompanying sensory symptoms of diabetic neuropathy. The neuropathic pain affected mainly dorsal part of the both feet and exacerbated in the evening, making it difficult to fall asleep.

Previous treatment

The patient was treated with gabapentin, pregabalin and anti-inflammatory drugs with only mild effect.

Treatment form Dr.Goczewski

The skin of the dorsum of the foot is innervated by a superficial peroneal nerve. The regeneration of both superficial peroneal nerves was done by injecting PRP around the nerves. The procedure was performed under ultrasound guidance.

Outcome

The treatment reduced the pain by 50%. It was enough for the patient to sleep normally at night.

Artykuł Diabetic neuropathy resistant to treatment pochodzi z serwisu Goczewski.

Chronic pain of the breastbone and the shoulder

Marcin Goczewski — Wed, 04 Aug 2021 14:37:26 +0000

Chronic pain of the breastbone and the shoulder

Patient’s history

The middle age woman has been diagnosed with acromio-clavicular and sterno-clavicular joint instability on the left side for many years. She could not sleep on the left shoulder. During daily activity she felt a popping sensation with associated pain. It was also difficult to drive a car.

Previous treatment

After many consultations the surgery was offered but the patient refused. She started searching the internet for an alternative method of treatment. Finally she came across some information about prolotherapy. Then she contacted some patients who were treated with prolotherapy. They convinced her to try. The first prolotherapy session took place in London with some improvement, for another session she decided to go to Poland.

Treatment form Dr. Goczewski

Under ultrasound guidance he injected dextrose 15% solution into a sterno-clavicular joint and acromio-clavicular joint.

Outcome

Patient’s condition improved after 2 weeks. She can normally sleep on the left shoulder, she can also drive a car. The popping sensation with pain occurs rarely.

Artykuł Chronic pain of the breastbone and the shoulder pochodzi z serwisu Goczewski.

Knee pain due to meniscus instability

Marcin Goczewski — Wed, 04 Aug 2021 14:37:07 +0000

Knee pain due to meniscus instability

Patient’s history

The middle-aged patient has been suffering from the medial knee pain for many years. The patient is an entrepreneur and lifts heavy things at work. The pain interfered with normal functioning and gets worse after work.During dynamic ultrasound meniscal degeneration and meniscal instability was diagnosed.

Previous treatment

Patient was treated with anti-inflammatory pills and rehabilitation without any long term improvement.

Treatment form Dr.Goczewski

Prolotherapy of meniscal ligaments was done in order to strengthen the ligaments and stabilize the meniscus.

Outcome

The knee pain disappeared. The patient went twice to mountains for skiing in the winter and can enjoy the life.

Artykuł Knee pain due to meniscus instability pochodzi z serwisu Goczewski.