Refractory Lumbar Pain Following Motor Vehicle Collision in a Geriatric Patient With Prior Lumbar Surgery: Clinical Resolution After Multimodal Conservative Spinal Structural Rehabilitation

Motor vehicle collisions frequently result in persistent spinal pain in older adults, particularly among patients with a history of lumbar surgery, where altered biomechanics and compensatory loading can complicate recovery. In this population, care is often directed toward symptom management despite limited evidence for durable improvement and higher risks associated with invasive interventions. Reports of successful conservative structural rehabilitation remain relatively uncommon. A 66-year-old female with previous lumbar fusion, cervical fusion, and mild left thoracic scoliosis presented with severe ongoing low back pain radiating into her lower extremity following a motor vehicle collision. This resulted in substantial functional limitation. After failing pharmacologic management and physical therapy, she underwent a 10-week multimodal conservative structural care program. This incorporated pulsed electromagnetic field therapy, extracorporeal shockwave therapy, and structural spinal rehabilitation. Post treatment, the patient demonstrated meaningful improvement, including reduced pain, improved function with Functional Rating Index scores decreasing from 22 to 11. The subject also reported resolution of radicular symptoms, independent unassisted ambulation, discontinuation of prescription analgesics, and radiographic improvement in sagittal alignment and spinal translation.