prolotherapy-lowback

As Seen On...

Low Back


lowback

IliolumbarLigamentRight IliolumbarLigamentLeft SIRight SILeft RightIlium LeftIlium RightLateralSacralBorder LeftLateralSacralBorder
Appearance


R1R2R3R4R5
L1L2L3L4L5

Palpation
1. Iliolumbar Ligament Right
2. Iliolumbar Ligament Left
3. SI Right
4. SI Left
5. Right Ilium
6. Left Ilium
7. Right Lateral Sacral Border
8. Left Lateral Sacral Border
9. Other

Observed Abnormality? Yes No

Sensation Intact? Yes No

Moves Extremities w/o Deficit? Yes No



Range of Motion

Flexion
FullLimited    LevelPainExplain
Extension
FullLimited    LevelPainExplain
Sidebending Right
FullLimited    LevelPainExplain
Sidebending Left
FullLimited    LevelPainExplain
Rotation
FullLimited    LevelPainExplain


Procedure Note
Consent
Skin Cleaned with Chlohexadine
Other

Tender Points Injected with:Dextrose PRP
Joint Injection:Dextrose PRP Stem Cell


Resolution of Symptoms? Yes No

Tolerated Well? Yes No
Procedural Sedation:
Dose

Dose

Dose