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